Department of Dental Clinic, Faculty of Pharmacy Dentistry and Nursing Federal University of Ceará Rua Monsenhor Furtado, S/N, Rodolfo Teófilo CE, 60430-355, Fortaleza, CE, Brazil
Med Oral Patol Oral Cir Bucal. 2024 Mar 1;29(2):e248-e254. doi: 10.4317/medoral.26237.
This study retrospectively analyzed the risk factors for oral mucositis (OM) during cetuximab treatment.
We screened patients using cetuximab and retrospectively evaluated the presence of OM based on medical records. We collected information from 2 years of evaluations. Patient medical records were reviewed to obtain data on chemotherapy cycle and dose, sex, age, primary tumor, TNM stage, and head and neck radiotherapy (HNR) history. The X2 test and multinomial logistic regression were used for statistical analysis (SPSS 20.0, p < 0.05).
Among 1831 patients, OM was showed in 750 in any grade (41%), during cetuximab treatment. Most patients were female (n=944, 51.6%), <70years-old (n=1149, 62.8%), had larynx cancer (n=789, 43.1%) in T4 (n=579, 47.7%), N0 (n=509, 52.6%) stages. Primary tumor surgery was performed in 1476 (80.6%) patients, radiotherapy in 606 (33.1%) patients and cetuximab protocols most used involved up to four cycles (n=1072, 58.5%) of <400mg (n=996, 54.4%) cetuximab doses. Female (OR [odds ratio] = 2.17, CI95% = 1.26-3.75), >70 years-old patients (OR = 16.02, CI95% = 11.99-21.41), with HHNR (OR = 1.84, 1.41-2.40), treated with >4 cycles (OR = 1.52, CI95% = 1.16-2.01) and high doses of cetuximab (OR = 3.80, CI95% = 2.52-5.71) are the greatest risk factors for OM.
Since the clinical benefit of cetuximab in the treatment of older patients is limited and there is a high OM, especially in women with head and neck treated with radiotherapy, high doses and a high number of cetuximab cycles must be administered with caution.
本研究回顾性分析了西妥昔单抗治疗过程中口腔黏膜炎（OM）的危险因素。
我们筛选了使用西妥昔单抗的患者，并根据病历回顾性评估 OM 的存在。我们收集了 2 年评估的数据。查阅患者病历以获取化疗周期和剂量、性别、年龄、原发肿瘤、TNM 分期和头颈部放疗（HNR）史等信息。采用 X2 检验和多项逻辑回归进行统计学分析（SPSS 20.0，p<0.05）。
在 1831 例患者中，750 例（41%）在接受西妥昔单抗治疗时出现 OM。大多数患者为女性（n=944，51.6%），<70 岁（n=1149，62.8%），T4 期（n=579，47.7%），N0 期（n=509，52.6%）原发肿瘤为喉癌。1476 例（80.6%）患者行原发肿瘤切除术，606 例（33.1%）患者行放疗，最常使用的西妥昔单抗方案为 4 个周期（n=1072，58.5%）<400mg（n=996，54.4%）的剂量。女性（OR[比值比] = 2.17，95%CI95%= 1.26-3.75）、>70 岁患者（OR = 16.02，95%CI95%= 11.99-21.41）、HHNR（OR = 1.84，1.41-2.40）、>4 个周期治疗（OR = 1.52，95%CI95%= 1.16-2.01）和高剂量西妥昔单抗（OR = 3.80，95%CI95%= 2.52-5.71）是 OM 的最大危险因素。
鉴于西妥昔单抗治疗老年患者的临床获益有限，且 OM 发生率较高，特别是接受放疗的头颈部女性，必须谨慎使用高剂量和高数量的西妥昔单抗周期。
