Factors influencing oral mucositis in patients receiving chemotherapy.
OBJECTIVE
Oral mucositis is a painful complication of chemotherapy and can greatly affect patients' morbidity and mortality. Findings from two previous studies suggested a decrease in the prevalence of chemotherapy-induced mucositis in patients with solid tumors. The purposes of this study were to follow a large cohort of outpatients to determine the prevalence of mucositis and to identify whether certain clinical factors were significant in the development of mucositis.


METHODS
In this prospective study, a convenience sample of 199 outpatients was followed for three cycles or until mucositis developed. The clinical factors monitored included the following: pretreatment dental examination/repair; initial standard chemotherapy dosage; prophylactic use of colony-stimulating factors; and use of preventive mouthwashes or other prophylactic measures.


RESULTS
Oral mucositis developed in 50 patients (25.1%). Prechemotherapy dental examination/repair and initial standard chemotherapy dosage were equivalent among both groups. Of the 48 patients in whom mucositis developed, 10 (20.8%) received prophylactic colony-stimulating factors. Of 134 patients in whom mucositis did not develop, 46 (34.3%) received prophylactic colony-stimulating factors. This difference was statistically nonsignificant.


CONCLUSIONS
Differences in the clinical factors investigated could not explain the lower prevalence of oral mucositis among the current patient cohort. The reason for the diminishing prevalence of this side effect remains unclear, and additional parameters, particularly detailed oral hygiene practices, should be evaluated. In the meantime, oncology clinicians should consider the teaching of patients and urging them to use good oral hygiene practices as necessary and potentially preventive measures against chemotherapy-induced mucositis.
Dodd
M J
MJ
University of California, San Francisco, Department of Physiological Nursing, Box 0610, San Francisco, CA 94143-0610, USA.
Miaskowski
C
C
Dibble
S L
SL
Paul
S M
SM
MacPhail
L
L
Greenspan
D
D
Shiba
G
G
D000553:Ambulatory Care; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009061:Mouth Mucosa; D009730:Nursing Assessment; D009910:Oral Hygiene; D010353:Patient Education as Topic; D015995:Prevalence; D011322:Primary Prevention / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013280:Stomatitis / Q000139:chemically induced* / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D011795:Surveys and Questionnaires
D000970:Antineoplastic Agents