Factors associated with severe oral mucositis and candidiasis in patients undergoing radiotherapy for oral and oropharyngeal carcinomas: a retrospective multicenter study of 326 patients
Factors associated with severe oral mucositis and candidiasis in patients undergoing radiotherapy for oral and oropharyngeal carcinomas: a retrospective multicenter study of 326 patients
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DOI：
10.1007/s00520-019-04885-z
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发表时间：
2020-03-01
影响因子：
3.1
通讯作者：
Komori, Takahide
中科院分区：
文献类型：
--
作者：
Nishii, Mika;Soutome, Sakiko;Komori, Takahide
目的本回顾性多中心研究旨在探讨口腔和口咽癌放疗患者发生严重口腔粘膜炎和念珠菌病的相关因素。方法326例口腔口咽癌放疗患者纳入研究。对患者的年龄、性别、体重指数、原发部位、糖尿病、血清白蛋白、肌酐、血红蛋白、白细胞和淋巴细胞、合并顺铂或西妥昔单抗、放疗方法、总放疗剂量、喂养方式、使用间隔器、盐酸毛果芸香碱和皮质类固醇软膏等进行调查，并采用多因素考克斯回归分析各变量与口腔黏膜炎和念珠菌病的关系。结果136例（41.7%）患者发生3级口腔粘膜炎。男性、口咽癌、低血红蛋白水平、低白细胞或淋巴细胞、同时使用顺铂或西妥昔单抗以及经口进食与重度口腔粘膜炎的发生率较高显著相关。口腔念珠菌感染101例（31.0%）。口咽癌、低白细胞计数和2级或2级以上的口腔粘膜炎与口腔念珠菌病的高发病率显著相关。使用局部类固醇软膏未发现是口腔念珠菌病的危险因素。结论本回顾性研究表明，某些因素可能使接受放疗的口腔和口咽癌患者发生严重的口腔粘膜炎和口腔念珠菌病。未来需要为高危病例建立严重口腔粘膜炎的预防策略。
Purpose The present retrospective multicenter study intended to investigate the factors associated with severe oral mucositis and candidiasis in patients undergoing radiotherapy for oral and oropharyngeal carcinomas. Methods A total of 326 patients who underwent radiotherapy for oral and oropharyngeal cancers were enrolled in the study. The patients' age, sex, body mass index, primary site, diabetes, serum albumin, creatinine, hemoglobin, leukocyte and lymphocyte, concurrent cisplatin or cetuximab, method of radiation, total radiation dose, feeding route, use of spacers, pilocarpine hydrochloride, and corticosteroid ointment were examined, and the associations of each variable with oral mucositis and candidiasis were analyzed by multivariate Cox regression analysis. Results Grade 3 oral mucositis occurred in 136 (41.7%) patients. Male sex, oropharyngeal cancer, low hemoglobin levels, low leukocytes or lymphocytes, concurrent cisplatin or cetuximab, and oral feeding were found to be significantly associated with a higher incidence of severe oral mucositis. Oral candidiasis occurred in 101 (31.0%) patients. Oropharyngeal cancer, low leukocyte count, and oral mucositis of grade 2 or higher were found to be significantly associated with a higher incidence of oral candidiasis. The use of a topical steroid ointment was not found to be a risk factor for oral candidiasis. Conclusions The present retrospective study demonstrated that certain factors may predispose patients with oral and oropharyngeal cancers receiving radiotherapy to develop severe oral mucositis and oral candidiasis. A preventive strategy for severe oral mucositis needs to be established in the future for high-risk cases.