Factors influencing oral mucositis in patients receiving chemotherapy

PURPOSE: Oral mucositis is a painful complication of chemotherapy and can g reatly affect patients' morbidity and mortality. Findings from two previous studies suggested a decrease in the prevalence of chemotherapy-induced muc ositis in patients with solid tumors. The purposes of this study were to fo llow a large cohort of outpatients to determine the prevalence of mucositis and to identify whether certain clinical factors were significant in the d evelopment of mucositis. DESCRIPTION OF STUDY: In this prospective study, a convenience sample of 19 9 outpatients was followed for three cycles or until mucositis developed. T he clinical factors monitored included the following: pretreatment dental e xamination/repair;initial standard chemotherapy dosage; prophylactic use of colony-stimulating factors; and use of preventive mouthwashes or other pro phylactic measures. RESULTS: Oral mucositis developed in 50 patients (25.1% ); Prechemotherapy dental examination/repair and initial standard chemother apy dosage were equivalent among both groups. Of the 48 patients in whom mu cositis developed, 10 (20.8%) received prophylactic colony-stimulating fact ors. Of 134 patients in whom mucositis did not develop, 46 (34.3%) received prophylactic colony-stimulating factors. This difference was statistically nonsignificant, CLINICAL IMPLICATIONS: Differences in the clinical factors investigated cou ld not explain the lower prevalence of oral mucositis among the current pat ient cohort. The reason for the diminishing prevalence of this side effect remains unclear, and additional parameters, particularly detailed oral hygi ene practices, should be evaluated. In the meantime, oncology clinicians sh ould consider the teaching of patients and urging them to use good oral hyg iene practices as necessary and potentially preventive measures against che motherapy-induced mucositis.