Occurrence of oral mucositis in women during oncological treatment of breast cancer in the Brazilian Northeast
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Abstract
Objective: To describe the occurrence of oral mucositis (OM) in women undergoing cancer treatment for breast cancer (BC). Methods: This is a retrospective, quantitative, and analytical study in medical records of women diagnosed with BC in an oncology service. Clinical data were collected regarding the occurrence and severity of OM according to the World Health Organization criteria and the cancer treatment experienced by the participants. Results: 196 women were included. Of these, 97 (49.5%) developed OM, 43.4% of which were grade 1 or 2 (low or moderate). The occurrence was higher in white women (OR 1.93; 95% CI 1.04 - 3.57; p = 0.035), with metastatic breast cancer (OR 5.46; 95% CI 1.79 - 16.64; p = 0.002) and who experienced taxane agents at some point during chemotherapy (OR 2.26; 95% CI 1.12 - 4.56; p = 0.02). The mean severity of OM in the entire sample was 0.8 ± 1.0, and in the affected women was 1.7 ± 0.7. The difference in the severity of OM by the variables was observed only among women with grade 2 and grade 3 fatigue (p = 0.03). Conclusions: OM is a common mucocutaneous toxicity in women with BC. Despite the low severity observed, care for women with BC undergoing cancer treatment must consider the possible risks and complications associated with OM, adopting strategies to prevent, monitor, and treat them.
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References
2. Maria OM, Eliopoulos N, Muanza T. Radiation-induced oral mucositis. Front Oncol. 2017;7:89. https://doi.org/10.3389/fonc.2017.00089 PMid:28589080 PMCid:PMC5439125
3. Riley P, Glenny AM, Worthington HV, Littlewood A, Fernandez Mauleffinch LM, Clarkson JE, et al. Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors. Cochrane Database Syst Rev. 2017;11(11):CD011990. https://doi.org/10.1002/14651858.CD011990.pub2 PMCid:PMC6486203
4. Thomsen M, Vitetta L. Adjunctive Treatments for the prevention of chemotherapy- and radiotherapy-induced mucositis. Integr Cancer Ther. 2018;17(4):1027-47. https://doi.org/10.1177/1534735418794885 PMid:30136590 PMCid:PMC6247548
5. Al Ibraheemi AA, Shamoun S. Incidence and risk factors of oral mucositis in patients with breast cancer who receiving chemotherapy in al-bashir hospital. Int J Hematol Oncol Stem Cell Res. 2016;10(4):217-223. PMID:27928476 PMCid:PMC5139941
6. Seiler S, Kosse J, Loibl S, Jackisch C. Adverse event management of oral mucositis in patients with breast cancer. Breast Care (Basel). 2014;9(4):232-7. https://doi.org/10.1159/000366246 PMid:25404881 PMCid:PMC4209263
7. Cinausero M, Aprile G, Ermacora P, Basile D, Vitale MG, Fanotto V, et al. New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury. Front Pharmacol. 2017;8:354. https://doi.org/10.3389/fphar.2017.00354 PMid:28642709 PMCid:PMC5462992
8. National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services [Internet]. Common Terminology Criteria for Adverse Events Version 4.0 (CTCAE) [updated 2020 Sep 09]. Avaiable from: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm
9. Goedendorp MM, Jacobsen PB, Andrykowski MA. Fatigue screening in breast cancer patients: identifying likely cases of cancer-related fatigue. Psychooncology. 2016;25(3):275-81. https://doi.org/10.1002/pon.3907 PMid:26202003 PMCid:PMC4932827
10. Reinertsen KV, Engebraaten O, Loge JH, Cvancarova M, Naume B, Wist E, et al. Fatigue during and after breast cancer therapy-a prospective study. J Pain Symptom Manage. 2017;53(3):551-60. https://doi.org/10.1016/j.jpainsymman.2016.09.011 PMid:28042070
11. Wang XS, Woodruff JF. Cancer-related and treatment-related fatigue. Gynecol Oncol. 2015;136(3):446-52. https://doi.org/10.1016/j.ygyno.2014.10.013 PMid:25458588 PMCid:PMC4355326
12. de Araújo AA, Varela H, de Medeiros CA, de Castro Brito GA, de Lima KC, de Moura LM, et al. Azilsartan reduced TNF-α and IL-1β levels, increased IL-10 levels and upregulated VEGF, FGF, KGF, and TGF-α in an oral mucositis model. PLoS One. 2015;10(2):e0116799. https://doi.org/10.1371/journal.pone.0116799 PMid:25689279 PMCid:PMC4331549
13. Krause CE, Otieno BA, Bishop GW, Phadke G, Choquette L, Lalla RV, et al. Ultrasensitive microfluidic array for serum pro-inflammatory cytokines and C-reactive protein to assess oral mucositis risk in cancer patients. Anal Bioanal Chem. 2015;407(23):7239-43. https://doi.org/10.1007/s00216-015-8873-1 PMid:26143063 PMCid:PMC4553140
14. Hagiwara Y, Shiroiwa T, Shimozuma K, Kawahara T, Uemura Y, Watanabe T, et al. Impact of adverse events on health utility and health-related quality of life in patients receiving first-line chemotherapy for metastatic breast cancer: Results from the SELECT BC Study. Pharmacoeconomics. 2018;36(2):215-23. https://doi.org/10.1007/s40273-017-0580-7 PMid:29043567 PMCid:PMC5805818
15. Mathew A, Achkar T, Abberbock S, Sandhu GS, Jacob ME, Villgran VD, et al. Prevalence and determinants of end-of-life chemotherapy use in patients with metastatic breast cancer. Breast J. 2017;23(6):718-22. https://doi.org/10.1111/tbj.12905 PMid:28845536 PMCid:PMC5675818
16. Zhang XH, Hao S, Gao B, Tian WG, Jiang Y, Zhang S, et al. A network meta-analysis for toxicity of eight chemotherapy regimens in the treatment of metastatic/advanced breast cancer. Oncotarget. 2016;7(51):84533-84543. https://doi.org/10.18632/oncotarget.13023 PMid:27811367 PMCid:PMC5356679
17. Watanabe T, Kuranami M, Inoue K, Masuda N, Aogi K, Ohno S, et al. Comparison of an AC-taxane versus AC-free regimen and paclitaxel versus docetaxel in patients with lymph node-positive breast cancer: Final results of the National Surgical Adjuvant Study of Breast Cancer 02 trial, a randomized comparative phase 3 study. Cancer. 2017;123(5):759-68. https://doi.org/10.1002/cncr.30421 PMid:28081304 PMCid:PMC6668007
18. Palappallil DS, Nair BL, Jayakumar KL, Puvathalil RT. Comparative study of the toxicity of 5-fluorouracil-adriamycin-cyclophosphamide versus adriamycin-cyclophosphamide followed by paclitaxel in carcinoma breast. Indian J Cancer. 2011;48(1):68-73. https://doi.org/10.4103/0019-509X.75836 PMid:21248442
19. Chaitanya NC, Garlapati K, Priyanka DR, Soma S, Suskandla U, Boinepally NH. Assessment of anxiety and depression in oral mucositis patients undergoing cancer chemoradiotherapy: a randomized cross-sectional study. Indian J Palliat Care. 2016;22(4):446-54. https://doi.org/10.4103/0973-1075.191797 PMid:27803567 PMCid:PMC5072237
20. Saito H, Watanabe Y, Sato K, Ikawa H, Yoshida Y, Katakura A, et al. Effects of professional oral health care on reducing the risk of chemotherapy-induced oral mucositis. Support Care Cancer. 2014 Nov;22(11):2935-40. https://doi.org/10.1007/s00520-014-2282-4 PMid:24854326 PMCid:PMC4183888
21. Stempniewicz A, Ceranowicz P, Warzecha Z. Potential Therapeutic effects of gut hormones, ghrelin and obestatin in oral mucositis. Int J Mol Sci. 2019;20(7):1534. https://doi.org/10.3390/ijms20071534 PMid:30934722 PMCid:PMC6479885