Department of Periodontology, Bernhard Gottlieb Klinik f. ZMK, Medical University of Vienna, Waehringerstr. 25a, 1090, Vienna, Austria.
Support Care Cancer. 2012 Jan;20(1):175-83. doi: 10.1007/s00520-011-1107-y. Epub 2011 Feb 18.
Chemotherapy-induced oral mucositis (CIOM) is a common side effect of cancer therapy that may lead to significant morbidity and interfere with the treatment plan. The present prospective, cross-sectional study intended to describe the prevalence of clinically relevant CIOM (CRCIOM) in outpatients receiving chemotherapy for solid tumors.
Intra-oral assessments were performed on 298 consecutively recruited patients, who had undergone at least 14 days of chemotherapy for solid tumors in our outpatient oncology department. The presence of CIOM was evaluated using the Oral Mucositis Assessment Scale. CRCIOM was defined as the presence of ulcers (≥ 1 cm(2)), severe erythema, and/or inability to eat solid foods (WHO grades 2-4). Furthermore, the current levels of oral hygiene and oral health were measured.
A low prevalence (18 patients, 6%) of CRCIOM was found in the investigated patient collective, including 1% of patients with severe (WHO grade 3/4) CIOM. In the CRCIOM group, 16 patients were male, and two were female; 8 patients with CRCIOM had received head and neck radiotherapy. A higher prevalence of CRCIOM was found in smoking patients (12.7% vs. 4.5%, p < 0.05) and in the patients who have not had a dental checkup within the preceding 12 months (11.2% vs. 3.0%, p < 0.01). Diabetes mellitus and low WBC appeared not to be associated with higher CRCIOM rates. The plaque and gingival indexes were significantly increased (p < 0.01) in the CRCIOM group.
Although CRCIOM was a rare event in the investigated patient population, our results emphasize that pre-treatment dental therapy and primary preventive measures (including oral hygiene instructions) can be improved. Before starting chemotherapy, increased awareness of individual risk factors, such as male sex, tobacco smoking, low dental checkup frequency, poor oral hygiene, and a reduced oral health status, could help to prevent CRCIOM.
化疗引起的口腔黏膜炎（CIOM）是癌症治疗的常见副作用，可能导致严重的发病率，并干扰治疗计划。本前瞻性、横断面研究旨在描述接受实体瘤化疗的门诊患者中临床相关 CIOM（CRCIOM）的患病率。
对 298 名连续招募的患者进行口腔内评估，这些患者在我们的肿瘤门诊接受了至少 14 天的实体瘤化疗。使用口腔黏膜炎评估量表评估 CIOM 的存在。CRCIOM 定义为存在溃疡（≥ 1 cm²）、严重红斑和/或无法食用固体食物（WHO 分级 2-4）。此外，还测量了当前的口腔卫生和口腔健康水平。
在所调查的患者群体中，CRCIOM 的患病率较低（18 例，6%），包括 1%的患者患有严重（WHO 分级 3/4）CIOM。在 CRCIOM 组中，16 名患者为男性，2 名患者为女性；8 名 CRCIOM 患者接受过头颈部放疗。吸烟患者的 CRCIOM 患病率较高（12.7%比 4.5%，p < 0.05），而在过去 12 个月内未进行牙科检查的患者中，CRCIOM 的患病率较高（11.2%比 3.0%，p < 0.01）。糖尿病和白细胞计数低似乎与更高的 CRCIOM 发生率无关。CRCIOM 组的菌斑和牙龈指数显著升高（p < 0.01）。
尽管在调查的患者人群中，CRCIOM 是一种罕见事件，但我们的研究结果强调，治疗前的牙科治疗和初级预防措施（包括口腔卫生指导）可以得到改善。在开始化疗之前，提高对个体危险因素（如男性、吸烟、低牙科检查频率、口腔卫生差和口腔健康状况不佳）的认识，可以帮助预防 CRCIOM。
