Risk factors for oral mucositis in patients with solid tumors under treatment with cetuximab: a retrospective cross-sectional study

• Joyce Ohana de Lima Martins ^[1] ; Marcela Maria Fontes Borges ^[1] ; Cássia Emmanuela Nóbrega Malta ^[1] ; Janaina Motta Guerra ^[2] ; André Alves Crispim ^[3] ; Bruna Carolina Coelho ^[3] ; Lúcio Flávio Gonzaga Silva ^[3] ; Paulo Goberlânio de Barros Silva ^[1]
  1. [1] Universidade Federal do Ceará

     Universidade Federal do Ceará

     Brasil

     
  2. [2] Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil
  3. [3] Hospital Haroldo Juaçaba, Ceará Cancer Institute, Fortaleza, Ceará, Brazil

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 29, Nº. 2 (March), 2024
• Idioma: inglés
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  • This study retrospectively analyzed the risk factors for oral mucositis (OM) during cetuximab treatment.

    We screened patients using cetuximab and retrospectively evaluated the presence of OM based on medical records. We collected information from 2 years of evaluations. Patient medical records were reviewed to obtain data on chemotherapy cycle and dose, sex, age, primary tumor, TNM stage, and head and neck radiotherapy (HNR) history. The X2 test and multinomial logistic regression were used for statistical analysis (SPSS 20.0, p < 0.05).

    Among 1831 patients, OM was showed in 750 in any grade (41%), during cetuximab treatment. Most patients were female (n=944, 51.6%), <70years-old (n=1149, 62.8%), had larynx cancer (n=789, 43.1%) in T4 (n=579, 47.7%), N0 (n=509, 52.6%) stages. Primary tumor surgery was performed in 1476 (80.6%) patients, radiotherapy in 606 (33.1%) patients and cetuximab protocols most used involved up to four cycles (n=1072, 58.5%) of <400mg (n=996, 54.4%) cetuximab doses. Female (OR [odds ratio] = 2.17, CI95% = 1.26-3.75), >70 years-old patients (OR = 16.02, CI95% = 11.99-21.41), with HHNR (OR = 1.84, 1.41-2.40), treated with >4 cycles (OR = 1.52, CI95% = 1.16-2.01) and high doses of cetuximab (OR = 3.80, CI95% = 2.52-5.71) are the greatest risk factors for OM.

    Since the clinical benefit of cetuximab in the treatment of older patients is limited and there is a high OM, especially in women with head and neck treated with radiotherapy, high doses and a high number of cetuximab cycles must be administered with caution.