Skip to main content

Advertisement

Log in

Measurement of oral mucositis in children: a review of the literature

  • Review Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Goals of work

The assessment of oral mucositis is important. There is a paucity of validated oral mucositis assessment instruments for use in children. This paper reviews the available mucositis measurement tools and their applicability to a paediatric population.

Materials and methods

Literature search of PUBMED™ and bibliography searches identified articles relevant to mucositis measurement tools and the measurement of mucositis in paediatrics.

Results

The relevant issues in the literature could be grouped into three categories: (1) development and evaluation of oral assessment tools, (2) oral assessment in the paediatric population, and (3) challenges to the assessment of oral mucositis in children. There were numerous validated mucositis assessment scales for use in adults. Only three of these scales have received limited evaluation for use in the paediatric population. The unique challenges presented by the paediatric population are excluded from much of the discussion in the literature.

Conclusion

The paper demonstrates the need to consider the issues specific to children. It must be determined whether previously developed tools are ideally suited for children enrolled on mucositis clinical trials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Western Consortium for Cancer Nursing Research (1991) Development of a staging system for chemotherapy-induced stomatitis. Cancer Nurs 14(1):6–12

    Google Scholar 

  2. Western Consortium for Cancer Nursing Research (1998) Assessing stomatitis: refinement of the Western Consortium for Cancer Nursing Research (WCCNR) stomatitis staging system. Can Oncol Nurs J 8 (3): 160– 165

    Google Scholar 

  3. Anderson PM, Schroeder G, Skubitz KM (1998) Oral glutamine reduces the duration and severity of stomatitis after cytotoxic cancer chemotherapy. Cancer 83(7):1433–1439

    Article  PubMed  CAS  Google Scholar 

  4. Andersson P, Persson L, Hallberg IR, Renvert S (1999) Testing an oral assessment guide during chemotherapy treatment in a Swedish care setting: a pilot study. J Clin Nurs 8(2):150–158

    Article  PubMed  CAS  Google Scholar 

  5. Aquino VM, Harvey AR, Garvin JH, Godder KT, Nieder ML, Adams RH et al (2005) A double-blind randomized placebo-controlled study of oral glutamine in the prevention of mucositis in children undergoing hematopoietic stem cell transplantation: a pediatric blood and marrow transplant consortium study. Bone Marrow Transplant 36(7):611–616

    Article  PubMed  CAS  Google Scholar 

  6. Beck S (1979) Impact of a systematic oral care protocol on stomatitis after chemotherapy. Cancer Nurs 2(3):185–199

    Article  PubMed  CAS  Google Scholar 

  7. Biron P, Sebban C, Gourmet R, Chvetzoff G, Philip I, Blay JY (2000) Research controversies in management of oral mucositis. Support Care Cancer 8(1):68–71

    Article  PubMed  CAS  Google Scholar 

  8. Brown CG, Wingard J (2004) Clinical consequences of oral mucositis. Semin Oncol Nurs 20(1):16–21

    Article  PubMed  Google Scholar 

  9. Chen CF, Wang RH, Cheng SN, Chang YC (2004) Assessment of chemotherapy-induced oral complications in children with cancer. J Pediatr Oncol Nurs 21(1):33–39

    Article  PubMed  Google Scholar 

  10. Cox JD, Stetz J, Pajak TF (1995) Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 31(5):1341–1346

    Article  PubMed  CAS  Google Scholar 

  11. Dibble SL, Shiba G, MacPhail L, Dodd MJ (1996) MacDibbs mouth assessment. A new tool to evaluate mucositis in the radiation therapy patient. Cancer Pract 4(3):135–140

    PubMed  CAS  Google Scholar 

  12. Dodd MJ, Facione NC, Dibble SL, MacPhail L (1996) Comparison of methods to determine the prevalence and nature of oral mucositis. Cancer Pract 4(6):312–318

    PubMed  CAS  Google Scholar 

  13. Donnelly JP, Muus P, Schattenberg A, De Witte T, Horrevorts A, DePauw BE (1992) A scheme for daily monitoring of oral mucositis in allogeneic BMT recipients. Bone Marrow Transplant 9(6):409–413

    PubMed  CAS  Google Scholar 

  14. Eilers J, Berger AM, Petersen MC (1988) Development, testing, and application of the oral assessment guide. Oncol Nurs Forum 15(3):325–330

    PubMed  CAS  Google Scholar 

  15. Eilers J, Epstein JB (2004) Assessment and measurement of oral mucositis. Semin Oncol Nurs 20(1):22–29

    Article  PubMed  Google Scholar 

  16. Fulton JS, Middleton GJ, McPhail JT (2002) Management of oral complications. Semin Oncol Nurs 18(1):28–35

    Article  PubMed  Google Scholar 

  17. Gibson F, Cargill J, Allison J, Begent J, Cole S, Stone J et al (2006) Establishing content validity of the oral assessment guide in children and young people. Eur J Cancer 42(12):1817–1825

    Article  PubMed  Google Scholar 

  18. Jaroneski LA (2006) The importance of assessment rating scales for chemotherapy-induced oral mucositis. Oncol Nurs Forum 33(6):1085–1090 (quiz 1091–1093)

    Article  PubMed  Google Scholar 

  19. Kennedy L, Diamond J (1997) Assessment and management of chemotherapy-induced mucositis in children. J Pediatr Oncol Nurs 14(3):164–174 (quiz 175–177

    Article  PubMed  CAS  Google Scholar 

  20. Lopez-Castano F, Onate-Sanchez RE, Roldan-Chicano R, Cabrerizo-Merino MC (2005) Measurement of secondary mucositis to oncohematologic treatment by means of different scale. Review. Med Oral Patol Oral Cir Bucal 10(5):412–421

    Google Scholar 

  21. Lutgens LC, Blijlevens NM, Deutz NE, Donnelly JP, Lambin P, de Pauw BE (2005) Monitoring myeloablative therapy-induced small bowel toxicity by serum citrulline concentration: a comparison with sugar permeability tests. Cancer 103(1):191–199

    Article  PubMed  Google Scholar 

  22. McGuire DB, Peterson DE, Muller S, Owen DC, Slemmons MF, Schubert MM (2002) The 20 item oral mucositis index: reliability and validity in bone marrow and stem cell transplant patients. Cancer Invest 20(7–8):893–903

    Article  PubMed  Google Scholar 

  23. McGuire DB, Yeager KA, Dudley WN, Peterson DE, Owen DC, Lin LS et al (1998) Acute oral pain and mucositis in bone marrow transplant and leukemia patients: data from a pilot study. Cancer Nurs 21(6):385–393

    Article  PubMed  CAS  Google Scholar 

  24. Meurman JH, Pyrhonen S, Teerenhovi L, Lindqvist C (1997) Oral sources of septicaemia in patients with malignancies. Oral Oncol 33(6):389–397

    PubMed  CAS  Google Scholar 

  25. Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47(1):207–214

    Article  PubMed  CAS  Google Scholar 

  26. National Cancer Institute (2003) Common toxicity criteria V3.0. National Cancer Institute, Bethesda, MD

    Google Scholar 

  27. Nelson W, Gibson F, Hayden S, Morgan N (2001) Using action research in paediatric oncology to develop an oral care algorithm. Eur J Oncol Nurs 5(3):180–189

    Article  PubMed  CAS  Google Scholar 

  28. Olson K, Hanson J, Hamilton J, Stacey D, Eades M, Gue D et al (2004) Assessing the reliability and validity of the revised WCCNR stomatitis staging system for cancer therapy-induced stomatitis. Can Oncol Nurs J 14(3):168–174, 176–182

    PubMed  Google Scholar 

  29. Parulekar W, Mackenzie R, Bjarnason G, Jordan RC (1998) Scoring oral mucositis. Oral Oncol 34(1):63–71

    Article  PubMed  CAS  Google Scholar 

  30. Riesenbeck D, Dorr W (1998) Documentation of radiation-induced oral mucositis. Scoring systems. Strahlenther Onkol 174(Suppl 3):44–46

    PubMed  Google Scholar 

  31. Schubert MM, Williams BE, Lloid ME, Donaldson G, Chapko MK (1992) Clinical assessment scale for the rating of oral mucosal changes associated with bone marrow transplantation. Development of an oral mucositis index. Cancer 69(10):2469–2477

    Article  PubMed  CAS  Google Scholar 

  32. Sonis ST (1993) Oral complications of cancer chemotherapy in pediatric patients. In: De Vita VT Jr, Hellman S, Rosenberg SA (eds) Principles and practices of oncology. 4th edn. Lippincott, Philadelphia

    Google Scholar 

  33. Sonis ST, Costello KA (1995) A database for mucositis induced by cancer chemotherapy. Eur J Cancer B Oral Oncol 31B(4):258–260

    Article  PubMed  CAS  Google Scholar 

  34. Sonis ST, Eilers JP, Epstein JB, LeVeque FG, Liggett WH Jr, Mulagha MT et al (1999) Validation of a new scoring system for the assessment of clinical trial research of oral mucositis induced by radiation or chemotherapy. Mucositis Study Group. Cancer 85(10):2103–2113

    CAS  Google Scholar 

  35. Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M et al (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100(9 Suppl):1995–2025

    Article  PubMed  Google Scholar 

  36. Spijkervet FK, van Saene HK, Panders AK, Vermey A, Mehta DM (1989) Scoring irradiation mucositis in head and neck cancer patients. J Oral Pathol Med 18(3):167–171

    Article  PubMed  CAS  Google Scholar 

  37. Stiff PJ, Erder H, Bensinger WI, Emmanouilides C, Gentile T, Isitt J et al (2006) Reliability and validity of a patient self-administered daily questionnaire to assess impact of oral mucositis (OM) on pain and daily functioning in patients undergoing autologous hematopoietic stem cell transplantation (HSCT). Bone Marrow Transplant 37(4):393–401

    Article  PubMed  CAS  Google Scholar 

  38. Sung L, Tomlinson GA, Greenberg ML, Koren G, Judd P, Ota S (2007) Validation of the oral mucositis assessment scale in pediatric cancer. Pediatr Blood Cancer 49(2):149–153

    Article  PubMed  Google Scholar 

  39. Tardieu C, Cowen D, Thirion X, Franquin JC (1996) Quantitative scale of oral mucositis associated with autologous bone marrow transplantation. Eur J Cancer B Oral Oncol 32B(6):381–387

    Article  PubMed  CAS  Google Scholar 

  40. Tooley KL, Saxon BR, Webster J, Zacharakis B, McNeil Y, Davidson GP et al (2006) A novel non-invasive biomarker for assessment of small intestinal mucositis in children with cancer undergoing chemotherapy. Cancer Biol Ther 5(10):1275–1281

    PubMed  CAS  Google Scholar 

  41. Walsh LJ, Hill G, Seymour G, Roberts A (1990) A scoring system for the quantitative evaluation of oral mucositis during bone marrow transplantation. Spec Care Dentist 10(6):190–195

    Article  PubMed  CAS  Google Scholar 

  42. Woo SB, Sonis ST, Monopoli MM, Sonis AL (1993) A longitudinal study of oral ulcerative mucositis in bone marrow transplant recipients. Cancer 72(5):1612–1617

    Article  PubMed  CAS  Google Scholar 

  43. World Health Organization (1979) Handbook for reporting results of cancer treatment. Geneva

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deborah Tomlinson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tomlinson, D., Judd, P., Hendershot, E. et al. Measurement of oral mucositis in children: a review of the literature. Support Care Cancer 15, 1251–1258 (2007). https://doi.org/10.1007/s00520-007-0323-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-007-0323-y

Keywords

Navigation