Prevalence of oral mucositis in children and adolescent undergoing chemotherapy

Abstract

OBJECTIVES: To study the prevalence of oral mucositis among paediatric and adolescent cancer patients receiving combination chemotherapy. METHODS: All cancer patients, aged 18 or under, within two weeks of receiving chemotherapy at the Children's Centre for Cancer and Blood Diseases, Queen Mary Hospital during the period from February through May 2011 were invited. Ethics approval (IRB UW 10-294) and parental consent were sought. Medical history was recorded and clinical examination was conducted by one examiner to study oral mucositis with WHO criteria. RESULTS: Forty one patients with mean age (±S.D) of 8.7±4.9 participated in the study. Among them, 24 (59%) had acute leukaemia, 12 (29%) had solid tumours and 5 (12%) with other haematological malignancies. Chemotherapeutic agents including antimetabolites, cytotoxic antibiotics, alkylating agents, and plant alkaloids were administered in 55%, 33%, 25%, and 23% of the patients, respectively. Hexetidine mouthwash was prescribed in patients receiving intensive chemotherapy (12%). Ten patients (24%) exhibited features of oral mucositis; among them, 40%, 40%, 10%, 10% presented with WHO grade 1, 2, 3, and 4 oral mucositis, respectively. Oral mucositis was found to be more common in patients with low white blood cell count (<3.5x109/L) (p = 0.007), being treated with cytotoxic antibiotics (p = 0.006) and with alkylating agents (p = 0.045). CONCLUSION: In contrary to adult experience, paediatric cancer patients had much lower prevalence of oral mucositis while they underwent chemotherapy. That may be due to the differences in the cancer types and treatment regimens used. We found that the manifestations of oral mucositis were associated with leucopenia, administration of cytotoxic antibiotics and alkylating agents.