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儿科肿瘤患者的口腔黏膜炎:一项前瞻性队列研究中的巢式病例对照研究

Oral Mucositis in Pediatric Oncology Patients: A Nested Case-Control to a Prospective Cohort.

作者信息

Ribeiro Isabella Lima Arrais, Melo Ana Carolina Rodrigues de, Limão Nayara Pereira, Bonan Paulo Rogério Ferreti, Lima Neto Eufrásio de Andrade, Valença Ana Maria Gondim

机构信息

Department of Social Medicine, USP - Universidade de São Paulo, Ribeirão Preto, Brazil.

UFPB - Universidade Federal da Paraíba, João Pessoa, Brazil.

出版信息

Braz Dent J. 2020 Jan-Feb;31(1):78-88. doi: 10.1590/0103-6440201802881.

Abstract

This study aimed to evaluate the factors associated with the occurrence of severe oral mucositis (SOM) in pediatric oncology patients during the chemotherapeutic treatment. This is a nested case-control to a prospective cohort that monitored 105 patients for 10 consecutive weeks after the beginning of the chemotherapy treatment. Logistic regression was used to identify the factors associated with SOM, by group of malignancy (hematologic or solid tumors) (Sig.=5%). To patients with hematologic tumors were found factors associated with SOM in two weeks of treatment: in the 6th week (increase in frequency of chemotherapy doses (OR=3.02)) and in the 7th week (female sex (OR=21.28); and increase in frequency of chemotherapy doses (OR=2.51)); and to patients with solid tumors were found factors associated with SOM in five weeks of treatment: in the 1st week (female sex (OR=14.43); age increase (OR=1.24)); in the 2nd week (Miscellany (OR=6.39)); in the 5th week (Antimetabolites (OR=17.44); Miscellany (OR=45.42); and platelets reduction (OR=1.12)); in the 6th week (creatinine increase (OR=1.63)); and in the 7th week (creatinine increase (OR=2.39)). For patients with hematologic tumors, to be female, and the increase in the frequency of chemotherapy doses increased the risk for SOM and for patients with solid tumors, to be female, the increase in age and in level blood concentration of creatinine, the reduction in number of platelets and the use of chemotherapy with miscellany and antimetabolites agents were associated with an increase in risk for occurrence of SOM.

摘要

本研究旨在评估小儿肿瘤患者化疗期间发生严重口腔黏膜炎(SOM)的相关因素。这是一项嵌套病例对照研究,针对一个前瞻性队列,该队列在化疗治疗开始后连续10周对105例患者进行监测。采用逻辑回归按恶性肿瘤类型(血液系统肿瘤或实体瘤)确定与SOM相关的因素(显著性水平=5%)。对于血液系统肿瘤患者,在治疗两周时发现与SOM相关的因素:第6周(化疗剂量频率增加(比值比=3.02))和第7周(女性(比值比=21.28);化疗剂量频率增加(比值比=2.51));对于实体瘤患者,在治疗五周时发现与SOM相关的因素:第1周(女性(比值比=14.43);年龄增加(比值比=1.24));第2周(其他(比值比=6.39));第5周(抗代谢药物(比值比=17.44);其他(比值比=45.42);血小板减少(比值比=1.12));第6周(肌酐升高(比值比=1.63));第7周(肌酐升高(比值比=2.39))。对于血液系统肿瘤患者,女性以及化疗剂量频率增加会增加SOM风险;对于实体瘤患者,女性、年龄增加、血肌酐水平升高、血小板数量减少以及使用其他和抗代谢药物化疗与SOM发生风险增加相关。

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