Pediatric Hemato-Oncology Unit, Children Hospital, Rabat, Morocco.
Int J Paediatr Dent. 2011 May;21(3):210-6. doi: 10.1111/j.1365-263X.2011.01113.x. Epub 2011 Mar 1.
To analyse the incidence and the determinants of severe oral mucositis (OM) in young cancer patients treated by standard chemotherapy.
The study was carried out at the Pediatric Hemato-Oncology unit of Children's Hospital of Rabat. Patients under 16 years of age with malignant disease treated by chemotherapy between January 2001 and December 2006 were recorded.
Consecutive patients (n = 970) with malignant disease were studied. The age ranges from 2 months to 16 years (mean, 6.8 ± 4.1 years). OM occurred in 540 (55.6%) patients, and 17.9% of them encountered severe grades. Mean time to onset of the lesions was 10.5 ± 6.8 (range, 1-22 days) and mean duration was 6.8 ± 3.1 (range, 2-23 days). All chemotherapeutic protocols were associated with OM development (range, 20-100%). Patients with severe OM were more likely to have undifferentiated carcinoma of nasopharyngeal type (RR = 2.6, 95% IC 1.1-6.1), non-Hodgkin lymphoma (RR = 2.1, 95% CI 1.2-2.4) and acute leukaemia (RR = 1.7, 95% CI 1.5-3.6). Methotrexate-based therapies were also associated with the worsening of OM (RR = 1.7, 95% IC 1.2-2.6).
Underlying disease and chemotherapy regimens are the principal risk factors of OM development. This model can help in the identification of patients at risk for adequate preventive and therapeutic measures.
分析标准化疗治疗的年轻癌症患者中严重口腔黏膜炎（OM）的发生率和决定因素。
该研究在拉巴特儿童医院儿科血液肿瘤科进行。记录了 2001 年 1 月至 2006 年 12 月期间接受化疗的恶性疾病的 16 岁以下患者。
研究了连续患有恶性疾病的患者（n=970）。年龄范围从 2 个月至 16 岁（平均，6.8±4.1 岁）。540 名（55.6%）患者发生 OM，其中 17.9%的患者出现严重等级。病变的平均发病时间为 10.5±6.8（范围，1-22 天），平均持续时间为 6.8±3.1（范围，2-23 天）。所有化疗方案均与 OM 发展相关（范围，20-100%）。严重 OM 患者更有可能患有未分化型鼻咽癌（RR=2.6，95%CI 1.1-6.1）、非霍奇金淋巴瘤（RR=2.1，95%CI 1.2-2.4）和急性白血病（RR=1.7，95%CI 1.5-3.6）。基于甲氨蝶呤的治疗也与 OM 恶化相关（RR=1.7，95%CI 1.2-2.6）。
基础疾病和化疗方案是 OM 发展的主要危险因素。该模型有助于识别有风险的患者，以便采取适当的预防和治疗措施。
