Post-Graduation Program in Dentistry, Federal University of Pernambuco (UFPE), Professor Moraes Rego Avenue, 1235, Recife, Pernambuco, Brazil.
Pathology Department, Federal University of Pernambuco (UFPE), Professor Moraes Rego Avenue, 1235, Recife, Pernambuco, Brazil.
Eur Arch Paediatr Dent. 2024 Aug;25(4):589-596. doi: 10.1007/s40368-024-00919-1. Epub 2024 Jul 5.
This study aimed to analyze, through a hierarchical model, the risk factors associated with the recurrence of chemo-induced oral mucositis (OM) in children and adolescents.
A retrospective cohort with 31 individuals of both sexes, aged 1-18 years, who were undergoing chemotherapy, and presented OM lesions was conducted. Data collection included analysis of medical records, interviews, and intraoral examination. Information regarding patients' socioeconomic and demographic profile, underlying disease, antineoplastic regimen, hematological condition, and oral health status were collected. To assess the association of independent variables with the outcome, the Chi-square, Fisher's Exact, and Mann-Whitney tests were used, in addition to a binary logistic regression model, with a maximum error of 5% and a 95% confidence interval.
Significant associations were observed between the history of OM and the diagnosis of the child/adolescent, neutrophil count, previous cancer treatments and the chemotherapy scheme in use (p < 0.05). Binary logistic regression revealed a 13.69 higher risk of developing OM recurrence in individuals who received high-dose methotrexate (MTX) therapy.
Socioeconomic and demographic factors did not influence OM recurrence. However, clinical variables, such as neutropenia, diagnosis of leukemia, and high-dose MTX protocols increase the chance of OM new cases.
本研究旨在通过分层模型分析与儿童和青少年化疗诱导性口腔黏膜炎(OM)复发相关的风险因素。
进行了一项回顾性队列研究,共纳入 31 名 1-18 岁的男女患儿,他们正在接受化疗,并出现 OM 病变。数据收集包括对病历、访谈和口腔检查的分析。收集了有关患者社会经济和人口统计学特征、潜在疾病、抗肿瘤方案、血液状况和口腔健康状况的信息。为了评估独立变量与结果的关联,使用了卡方检验、Fisher 精确检验和曼-惠特尼检验,以及二元逻辑回归模型,最大误差为 5%,置信区间为 95%。
OM 病史与患儿/青少年的诊断、中性粒细胞计数、既往癌症治疗和正在使用的化疗方案之间存在显著关联(p<0.05)。二元逻辑回归显示,接受高剂量甲氨蝶呤(MTX)治疗的个体发生 OM 复发的风险增加了 13.69 倍。
社会经济和人口统计学因素并不影响 OM 复发。然而,中性粒细胞减少症、白血病诊断和高剂量 MTX 方案等临床变量增加了 OM 新发病例的几率。