Bahari Hanae, Ghanam Ayad, Hajaj Hanane, Elouali Aziza, Babakhouya Abdeladim, Rkain Maria
Department of Pediatrics, Mohammed VI University Hospital, Oujda, MAR.
Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR.
Cureus. 2025 Apr 24;17(4):e82885. doi: 10.7759/cureus.82885. eCollection 2025 Apr.
Introduction Chemotherapy-induced mucositis is a common and debilitating complication in pediatric oncology patients, characterized by painful inflammation of the oral and gastrointestinal mucosal membranes. It commonly contributes to a decline in the quality of life, an elevated risk of infections, and prolonged durations of hospitalization. Management involves both preventive and therapeutic measures intended to reduce symptoms and prevent the onset of complications. This study aims to evaluate the clinical characteristics, associated risk factors, and the effectiveness of therapeutic strategies in managing chemotherapy-induced mucositis in children treated at the Pediatric Oncology Unit of Mohammed VI University Hospital in Oujda. Materials and methods This retrospective study was conducted over 14 months, from July 2022 to August 2023, at the Pediatric Oncology Unit of Centre Hospitalier Universitaire Mohammed VI, Oujda. One hundred and forty-five pediatric patients receiving chemotherapy were included in the study. Data were systematically collected and recorded in an Excel file to document relevant clinical, demographic, laboratory, and treatment information. Results The age of the patients ranged from three to 16 years, with a male predominance of 66% (96 cases). In 51% of the patients (74 cases), a history of oral mucositis episodes was reported. Common hematologic malignancies observed were leukemia (41.3%; 60 cases), followed by lymphoma (20.6%; 30 cases), neuroblastoma (13.7%; 20 cases), bone tumor (10.3%; 15 cases), retinoblastoma (7.6%; 11 cases) and other tumors (6.2%; 9 cases). Psychological distress, including anxiety, was present in 66% of patients. Almost all patients exhibited anorexia and refused to eat. The intensity of pain, evaluated using the Visual Analog Scale (VAS), ranged from 4 to 9/10, necessitating opioid analgesia in certain cases. Laboratory findings revealed neutropenia in 80% (116 cases), lymphopenia in 33% (48 cases), and an elevated C-reactive protein (CRP) in 79% (114 cases) of the patients. The treatment approach involved the administration of topical antifungal agents and meticulous oral hygiene, which included the use of bicarbonate mouthwashes. In severe cases, intravenous antibiotic therapy was initiated along with multimodal analgesic management. Conclusion Oral mucositis is a frequent and severe side effect of chemotherapy, associated with considerable morbidity and a decline in quality of life, underscoring the importance of prompt diagnosis and intervention.
引言
化疗引起的粘膜炎是儿科肿瘤患者常见且使人虚弱的并发症,其特征为口腔和胃肠道粘膜的疼痛性炎症。它通常会导致生活质量下降、感染风险升高以及住院时间延长。管理措施包括预防和治疗措施,旨在减轻症状并预防并发症的发生。本研究旨在评估在乌季达穆罕默德六世大学医院儿科肿瘤科接受治疗的儿童化疗引起的粘膜炎的临床特征、相关危险因素以及治疗策略的有效性。
材料与方法
这项回顾性研究于2022年7月至2023年8月在乌季达穆罕默德六世大学中心医院儿科肿瘤科进行了14个月。145名接受化疗的儿科患者被纳入研究。数据被系统地收集并记录在一个Excel文件中,以记录相关的临床、人口统计学、实验室和治疗信息。
结果
患者年龄在3至16岁之间,男性占主导,为66%(96例)。51%的患者(74例)报告有口腔粘膜炎发作史。观察到的常见血液系统恶性肿瘤为白血病(41.3%;60例),其次是淋巴瘤(20.6%;30例)、神经母细胞瘤(13.7%;20例)、骨肿瘤(10.3%;15例)、视网膜母细胞瘤(7.6%;11例)和其他肿瘤(6.2%;9例)。66%的患者存在包括焦虑在内的心理困扰。几乎所有患者都表现出厌食并拒绝进食。使用视觉模拟量表(VAS)评估的疼痛强度为4至9/10,在某些情况下需要使用阿片类镇痛药。实验室检查结果显示,80%(116例)的患者出现中性粒细胞减少,33%(48例)的患者出现淋巴细胞减少,79%(114例)的患者C反应蛋白(CRP)升高。治疗方法包括局部应用抗真菌药物和细致的口腔卫生护理,其中包括使用碳酸氢盐漱口水。在严重情况下,开始静脉抗生素治疗并进行多模式镇痛管理。
结论
口腔粘膜炎是化疗常见且严重的副作用,与相当高的发病率和生活质量下降相关,凸显了及时诊断和干预的重要性。