Mohan Minu Ponnamma, Pili Roberto, Epstein Joel B, Rudin Lauryn, Eichhorn Susan, Satheeshkumar Poolakkad S
Boston Medical Center, Boston University School of Medicine, Boston, MA, 02118, USA.
Department of Medicine, Division of Hematology and Oncology, University at Buffalo, Buffalo, NY, 14203, USA.
Support Care Cancer. 2024 Dec 12;33(1):22. doi: 10.1007/s00520-024-09071-4.
Our study aims to assess the association between chemotherapy-induced oral ulcerative mucositis (CT-UM) or radiotherapy-induced oral ulcerative mucositis (RT-UM) and the burden of illness (BOI), dysphagia, and disparities among patients with cancers of the oral cavity, lip, and pharynx (CLOP) and hematopoietic stem cell transplant patients (HSCT).
The study used US national data to investigate the association between UM and the BOI-length of stay (LOS) and dysphagia. The BOI was measured by length of stay (LOS), dysphagia, and associated disparities in these outcomes. This investigation was conducted using generalized linear models (glm).
An analysis was conducted on a sample of 820 patients with CT-UM and 1010 patients with RT-UM, out of a total of 59,710 hospitalized CLOP patients, and 1380 patients with CT-UM from 10,885 total hospitalized HSCT patients. Among, CLOP patients, CT-UM status was associated with increased LOS (Coeff,1.54; 95% CI 1.36 to 1.74) and also associated with a greater likelihood of dysphagia (aOR, 2.11; 95% CI 1.52-2.95). However, among CLOP, RT-UM status was also associated with increased LOS (Coeff, 1.33; 95% CI 1.14-1.55), but there was no association of d RT-UM status and dysphagia (aOR = 1.21; 95% CI 0.84-1.77). Among HSCT patients, CT-UM status was associated with increased LOS and greater likelihood of dysphagia (Coeff, 1.09; 95% CI 1.02-1.16 and aOR = 2.08; 95% CI 1.11-3.9, respectively). Further, UM outcomes disproportionately affect females, Blacks, Hispanics, Medicaid recipients, and those with lower incomes.
The findings highlight the need for more effective methods of screening for and preventing UM in order to decrease BOI, especially in the context of systemic treatments. Additionally, new computational methods including artificial intelligence for mucositis prediction should be the center of future studies.
我们的研究旨在评估化疗引起的口腔溃疡性粘膜炎（CT-UM）或放疗引起的口腔溃疡性粘膜炎（RT-UM）与疾病负担（BOI）、吞咽困难以及口腔、唇和咽癌（CLOP）患者和造血干细胞移植患者（HSCT）之间的差异之间的关联。
该研究使用美国国家数据调查UM与BOI（住院时间长度）和吞咽困难之间的关联。BOI通过住院时间长度、吞咽困难以及这些结果中的相关差异来衡量。这项调查使用广义线性模型（glm）进行。
在总共59710名住院的CLOP患者中，对820名CT-UM患者和1010名RT-UM患者的样本进行了分析，在总共10885名住院的HSCT患者中，对1380名CT-UM患者进行了分析。在CLOP患者中，CT-UM状态与住院时间增加相关（系数，1.54；95%置信区间1.36至1.74），也与吞咽困难的可能性增加相关（调整后比值比，2.11；95%置信区间1.52 - 2.95）。然而，在CLOP患者中，RT-UM状态也与住院时间增加相关（系数，1.33；95%置信区间1.14 - 1.55），但RT-UM状态与吞咽困难无关联（调整后比值比 = 1.21；95%置信区间0.84 - 1.77）。在HSCT患者中，CT-UM状态与住院时间增加和吞咽困难的可能性增加相关（系数，1.09；95%置信区间1.02 - 1.16和调整后比值比 = 2.08；95%置信区间1.11 - 3.9，分别）。此外，UM结果对女性、黑人、西班牙裔、医疗补助接受者和低收入者的影响尤为严重。
研究结果强调需要更有效的UM筛查和预防方法，以降低BOI，特别是在全身治疗的情况下。此外，包括人工智能用于粘膜炎预测的新计算方法应成为未来研究的重点。
