Multivariate analysis of chemotherapy induced oral mucositis in patients with head and neck tumors / 国际肿瘤学杂志

ABSTRACT

Objective:To investigate the influencing factors of chemotherapy induced oral mucositis (CIOM) in patients with head and neck tumors.Methods:The clinical data of 98 patients with head and neck tumors treated in Nantong Tumor Hospital of Jiangsu Province from July 2017 to July 2021 were analyzed retrospectively. The patients were divided into CIOM group ( n=82) and non-CIOM group ( n=16) according to whether CIOM occurred after chemotherapy. The general clinical data of the two groups were compared, and the levels of serum cystatin C (Cys-C) , hypersensitive C-reactive protein (hs-CRP) and homocysteine (Hcy) before chemotherapy of the two groups were detected and compared. Multivariate logistic regression analysis was used to explore the influencing factors of CIOM. Results:There were statistically significant differences in body mass index (BMI) ( χ2=6.44, P=0.011) , oral care ( χ2=4.36, P=0.037) , smoking history ( χ2=7.82, P=0.005) , oral pH value ( χ2=26.16, P<0.001) , radiotherapy history ( χ2=13.31, P<0.001) , chemotherapy regimen ( χ2=4.53, P=0.033) , application of antibiotics ( χ2=14.53, P<0.001) and application of oral mucosal protective agents ( χ2=12.85, P=0.001) between the CIOM group and non-CIOM group. The serum Cys-C [ (1.43±0.36) mg/L vs. (1.05±0.28) mg/L], hs-CRP [ (19.64±2.05) μmol/L vs. (13.49±1.55) μmol/L] and Hcy [ (14.34±1.71) μmol/L vs. (9.63±1.38) μmol/L] before chemotherapy of the CIOM group were significantly higher than those of the non-CIOM group, with statistically significant differences ( t=3.88, P<0.001; t=11.38, P<0.001; t=10.36, P<0.001) . Multivariate logistic regression analysis showed that BMI<18.5 kg/m 2 ( OR=1.66, 95% CI 1.18-2.14, P=0.005) , poor oral care ( OR=2.42, 95% CI 1.70-4.36, P=0.013) , smoking history ( OR=1.53, 95% CI 1.25-2.28, P=0.003) , oral pH≤7 ( OR=2.46, 95% CI 1.48-4.06, P<0.001) , radiotherapy history ( OR=2.04, 95% CI 1.60-3.44, P<0.001) , chemotherapy regimen containing fluorouracil (5-FU) ( OR=1.81, 95% CI 1.36-2.83, P=0.006) , and increased Cys-C ( OR=2.03, 95% CI 1.40-3.02, P<0.001) , hs-CRP ( OR=2.26, 95% CI 1.64-3.19, P<0.001) and Hcy ( OR=1.77, 95% CI 1.27-2.53, P<0.001) before chemotherapy were independent risk factors for the occurrence of CIOM in patients with head and neck tumors, while the application of antibiotics ( OR=0.76, 95% CI 0.43-0.95, P<0.001) and oral mucosal protective agents ( OR=0.58, 95% CI 0.27-0.88, P<0.001) were independent protective factors for the occurrence of CIOM in patients with head and neck tumors. Conclusion:BMI<18.5 kg/m 2, poor oral care, smoking history, oral pH≤7, radiotherapy history, chemotherapy regimen containing 5-FU, increased Cys-C, hs-CRP and Hcy before chemotherapy are independent risk factors of head and neck tumors patients complicated with CIOM, while the application of antibiotics and oral mucosal protective agents are independent protective factors.