Identification of factors associated with the severity of oral mucositis in patients receiving cancer chemotherapy

Objective: To investigate the risk factors affecting the onset and severity of oral mucositis in Japanese patients with cancer undergoing chemotherapy. Methods: Patients who underwent chemotherapy at a regional cancer hospital between January 20, 2017, and October 30, 2019, were enrolled in the study. Patients aged 20–80 years with malignant tumors underwent inpatient chemotherapy treatment and gave consent to participate in the study. Oral hygiene, immunocompetence, and nutritional status were assessed. The Common Terminology Criteria for Adverse Events Version 5.0 was used to assess the severity of adverse responses, and patients with oral mucositis grades 0–1 were assigned to group 1 and those grade 2 or higher to group 2. Results: Seventy patients were enrolled. Sixteen treatment plans were found. Group 1 had 45 patients and group 2 had 25. The following factors were related to oral mucositis severity: caries, periodontitis, unsuitable dentures (p = .041), frequency of toothbrushing (p = .024), and leukocytopenia grade 3 or higher (p = .030). There were no differences between the two groups in terms of oral hygiene, such as tongue coating and frequency of gargling, or the serum albumin and total protein levels. The risk factors for oral mucositis grade 2 or higher included the presence of caries, periodontal disease, unsuitable dentures (p = .041), toothbrushing twice daily or less (p = .024), and leukocytopenia grade 3 or higher (p = .030). Conclusions: Monitoring oral health and adopting preventive measures before and after chemotherapy can help manage oral mucositis in patients with cancer.