Oral Problems in Oncology Patients Undergoing Chemotherapy for Solid Tumors: A Prospective Observational Study.

PURPOSE: Oral problems in a group of oncological patients undergoing chemotherapy (CT) for solid tumors have been examined. Incidence and severity of patients' self-reported oral problems have been evaluated along their interaction with age, gender, tumor diagnosis and stage, presence of mestastasis, CT agent type, and number of CT cycle. We also analyzed the presence of paraesthesia and anaesthesia and their predisposing factors associated with clinical and treatment-related variables. METHODS: Patients were asked to fill in a questionnaire to evaluate the onset and the intensity of oral and perioral pain, oral mucositis, salivary gland hypofunction, dysgeusia, dysphagia, dysphonia, and sensitivity neuropathy (paraesthesia or dysaesthesia) since the last CT infusion. We also investigated which types of medications have possibly been used and who recommended it, as well as patients' degree of awareness about the possibility of oral problems arising during CT. RESULTS: We recruited 194 patients and obtained 491 questionnaires. We found that a metastatic disease was a risk factor for OM (OR 2.02, p = 0.026) and salivary gland hypofunction (OR 1.66, p = 0.042) and that platinum agents, compared to mitotic inhibitors, increased the risk of developing salivary gland hypofunction (OR 2.16, p = 0.013), dysphagia (OR 3.26, p = 0.001), and anaesthesia (OR 5.16, p = 0.041). Young age was a slight protective factor for most symptoms. The 80% of enrolled patients were informed by the oncologist about possible oral problems arising during CT. CONCLUSIONS: Our study highlighted the importance of collecting observational data from the patients' perspective on oral problems arising during the routine oncology practice, across a range of solid tumors and CT regimens. The relevance of these findings focused on the key role of the multidisciplinary team in advising the patients on the possible occurrence of oral problems, also by recommending their management.

Chemotherapy-associated oral complications in a south Indian population: a cross-sectional study.

Over the years, chemotherapy (CT) has evolved as an essential therapeutic modality for cancer, with oral manifestations frequently encountered as complications of cancer CT. Our study aimed to assess the prevalence of oral complications during CT and evaluate the significance of independent risk factors (age, gender, socio-economic status, oral hygiene practices etc). A cross-sectional study was carried out in a tertiary cancer hospital in Bhubaneswar, Odisha, India, in which a total of 138 hospitalized patients undergoing CT and fulfilling the inclusion and exclusion criteria were included. Comprehensive history and rigorous clinical examination eliciting the oral manifestations were carried out. Around 60% of patients exhibited oral manifestations. Xerostomia and lichenoid reactions were the highest and lowest recorded manifestations. Higher frequencies of oral lesions occurred in patients with breast cancer, TNM stage III, and with the administration of the docetaxel. Also, patients in the older age group, poor socio-economic status, poor quality of life, poor oral hygiene practices, and longer CT duration demonstrated more oral lesions. Individuals subjected to a dental evaluation either before or during CT exhibited a reduction in the number of oral features. Several oral complications were reported in the present study. All patients undergoing chemotherapy must receive reinforcement of oral hygiene instructions and dental evaluation before, during, and after chemotherapy treatment. The study also emphasizes the importance of oral health physician inclusion in the multidisciplinary cancer treatment team.

PERIODONTAL RESPONSE TO CYTOSTATIC DRUGS IN CHILDREN.

OBJECTIVE: The aim: To study the effect of different types of cytostatic drugs on the periodontium in children with malignant tumors. PATIENTS AND METHODS: Material and methods: The material for generalization was based at the results of examination of 44 patients with malignant tumors of the abdominal cavity who underwent preoperative treatment in the oncohematology department of Poltava Children's City Clinical Hospital. RESULTS: Results: In the absence of proper dental care in patients of this group, under the influence of chemotherapeutic drugs, significantly worsens the level of oral hygiene and the condition of periodontal tissues. There are also changes in the process of differentiation of the epithelial structures of the gingival margin, which is accompanied by an increase in smears - reprints of the number of inflammatory cells of the peripheral blood, both with preserved structure and destructive forms. CONCLUSION: Conclusions: In children with malignant tumors, during antitumor therapy, there is a decrease in the level of hygiene of the oral cavity, accompanied by morphological destructive changes in the integumentary epithelial layer of the gingival margin. The severity of these disorders depends on the type and dose of cytostatic drugs, which should be considered in the formation of treatment and prevention measures for them.

Estomatotoxicidad bucal inducida por quimioterapia / Chemotherapy-induced oral stomatotoxicity

El objetivo principal de este estudio fue determinar el tipo de lesiones bucales más frecuentes en las pacientes con cáncer de mama tratadas con quimioterapia en el Hospital General de México, y establecer en qué condiciones se presentan dichas manifestaciones. Se realizó una revisión de expedientes entre los años de 1994 y 1999, estableciendo los criterios de inclusión y exclusión. De un total de 405 que fueron considerados, se incluyeron en la muestra 327 expedientes. De ellos, la incidencia de estomatotoxicidad se presentó en 122 casos, 89 de los cuales presentaron una sola manifestación bucal, 19 presentaron dos, y 14 pacientes reportaron más de dos. La relación entre la estirpe histológica del tumor se refleja presentándose en el canalicular infiltrante, lobular y otros (p < .005). Los esquemas de tratamiento con quimioterapia fueron integrados con: 5-fluoracilo, adriamicina, ciclofosfamida y metotrexato (p < .005). La dosis y estomatotoxicidad se relacionaron con p < .005.

The principal aim of the present study was to determine the type of oral lesions most frequently found in breast cancer patients treated with chemotherapy at the General Hospital in Mexico City and establish under which circumstances these manifestations occur. A file review was undertaken, spanning from 1994 to 1999. Inclusion and exclusion criteria were established. Out of 405 cases under consideration, 327 cases were included in the sample. In these selected cases, stomatotoxicity was present in 129 cases: 89 cases exhibited only a single oral manifestation, 19 cases showed two and 14 cases exhibited more than two (three or more). Relationship between histological lineage was reflected; it was present in the infiltrating ducts, lobular and others (p < .005). Treatment schemes with chemotherapy were integrated with 5-fluorouracil, adriamycin, cyclophosphamide and methrotrexate (p < .005) dosage and stomatotoxicity were related (p < .005).