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Impact of oral mucositis on short-term clinical outcomes in paediatric and adolescent patients undergoing chemotherapy

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Abstract

Purpose

The purpose of this study is to determine the burden of the peak severity of oral mucositis and severity over time on selected clinical outcomes in paediatric and adolescent patients receiving chemotherapy.

Patients and methods

A multicentre study enrolled 140 patients between the ages of 6 and 18 years, who had been treated with chemotherapy and completed the self-report Mouth and Throat Soreness-related questions of the Oral Mucositis Daily Questionnaire for 14 days. Clinical data were collected from patients' medical records during the first 14 days after starting chemotherapy.

Results

Forty-one percent developed oral mucositis. Multiple linear regression analysis revealed that oral mucositis was significantly associated with an increased loss of baseline body weight, after controlling for nausea/vomiting (β = 0.34, p = 0.002). Multiple logistic regression analysis showed that severe mucositis was significantly associated with a higher probability of fluid replacement, after controlling for nausea/vomiting (adjusted OR = 12.8; 95 % CI = 2.7–61.0; p = 0.001). In addition, severe mucositis was significantly associated with a higher probability of fever, after controlling for neutropoenia (adjusted OR = 5.4; 95 % CI = 1.8–15.4; p = 0.002). No difference was observed for oral or systemic infections among the subgroups. About 5 % of the patients with oral mucositis had delays in chemotherapy (≤7 days). None of the patients had dose modification or unplanned hospitalization due to oral mucositis. The associations of peak severity and overall oral mucositis with adverse clinical outcomes in paediatric and adolescent patients were equivalent.

Conclusion

Oral mucositis is associated with negative effects on clinical outcomes.

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Acknowledgments

This study was supported by a grant from the Health, Welfare and Food Bureau of Hong Kong. We thank the physicians and nursing staff who were involved in various aspects of this study. Our special thanks go to all patients and their parents who gave their time to this study.

Conflicts of interest

None of the authors has any financial and personal relationships with other people or organizations that could inappropriately influence their work.

Author information

Authors and Affiliations

  1. Alice Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore

    Karis Kin Fong Cheng & Hong Gu He

  2. Department of Paediatrics, Children Cancer Centre, Prince of Wales Hospital, Sha Tin, Hong Kong

    Vincent Lee

  3. Department of Paediatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong

    Chak Ho Li

  4. Department of Paediatrics, Queen Elizabeth Hospital, Kowloon, Hong Kong

    Hui Leung Yuen

  5. The Nethersole School of Nursing, The Chinese University of Hong Kong, Sha Tin, Hong Kong

    Wan Yim Ip

  6. Division of Otolaryngology and Head and Neck Surgery, City of Hope National Medical Center, Duarte, CA, USA

    Joel B. Epstein

  7. Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Joel B. Epstein

Authors
  1. Karis Kin Fong Cheng
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  2. Vincent Lee
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  3. Chak Ho Li
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  4. Hui Leung Yuen
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  5. Wan Yim Ip
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  6. Hong Gu He
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  7. Joel B. Epstein
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Corresponding author

Correspondence to Karis Kin Fong Cheng.

Additional information

This study was supported by the Health and Health Services Research Fund of the Health, Welfare and Food Bureau of Hong Kong.

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Cheng, K.K.F., Lee, V., Li, C.H. et al. Impact of oral mucositis on short-term clinical outcomes in paediatric and adolescent patients undergoing chemotherapy. Support Care Cancer 21, 2145–2152 (2013). https://doi.org/10.1007/s00520-013-1772-0

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  • DOI: https://doi.org/10.1007/s00520-013-1772-0

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