Klinik Araştırma
BibTex RIS Kaynak Göster

The Effect of Oral Care Protocols on Mucositis in Pediatric Cancer Patients: A Randomized Controlled Trial

Yıl 2024, Cilt: 14 Sayı: 4, 180 - 188, 31.07.2024
https://doi.org/10.16899/jcm.1475337

Öz

Background/Aims: Standard oral care protocols can reduce the incidence of mucositis. This study aimed to evaluate the effect of the "Oral Care Protocol" containing sodium bicarbonate or saline on mucositis development, degree, and duration in pediatric cancer patients.


Methods: This study is a blind, parallel trial design, randomized controlled study. Patients (n = 43) who received inpatient chemotherapy treatment for more than three days at the Pediatric Hematology and Oncology Unit were included. The oral care protocol with saline was given to the patients in the control group (n = 22), and the oral care protocol with sodium bicarbonate was given to the patients in the study group (n = 21). The primary outcome was the development of mucositis. The secondary outcomes were mucositis degree, patient data at the time of mucositis development, and the duration of mucositis. The characteristics of the patients in the study and control groups and the data of patients with and without mucositis were compared with Fisher's exact test, t-test, and chi-square analysis.


Results: No statistically significant difference was found between the study and control groups in terms of mean age, gender, diagnosis, relapse status, treatment stage, risk group, and treatment protocols. Mucositis developed in 18.2% of the patients in the control group and 9.5% of the patients in the study group. No statistically significant difference was found in terms of mucositis development, degree, and duration.

Conclusions: The oral care protocol with sodium bicarbonate can be used to prevent mucositis in pediatric cancer patients. ClinicalTrials.gov Identifier: NCTXXX.

Etik Beyan

This study approved by the Non-Invasive Clinical Studies Ethics Committee of Dokuz Eylül University (3481GOA 2019/03-55).

Destekleyen Kurum

Non-Invasive Clinical Studies Ethics Committee of Dokuz Eylül University (3481GOA 2019/03-55).

Kaynakça

  • 1. Braguês R, Marvão MF, Correia P, Silva RM. Oral Mucositis Management in Children under Cancer Treatment: A Systematic Review. Cancers. 2024;16(8):1548.
  • 2. Anwer DJ, Ahmed K, Abdulla B. The Effect of Oral-care Program and Mouthwash Use as a Prophylaxis in Minimizing the Incidence of Chemotherapy-Induced Oral Mucositis of Pediatric and Adolescent Cancer Patients. Sulaimani Dent J 2020;7:16–24.
  • 3. Perry AD, Iida H, Patton LL, Wilder RS. Knowledge, Perceived Ability and Practice Behaviors Regarding Oral Health among Pediatric Hematology and Oncology Nurses. J Dent Hygiene, 2015;89:219–28.
  • 4. Spurr S, Bally J, Ogenchuk M. Integrating oral health into pediatric nursing practice:Caring for kids where they live. J Spec Pediatr Nurs 2015;20:105–14.
  • 5. El Bousaadani A, Eljahd L, Abada R, et al. Prevention and treatment of mucositis in children with oral cancers:Practical recommendations. Cancer Radiother 2016;20:226–30.
  • 6. Hashemi A, Bahrololoumi Z, Khaksar Y, et al. Mouth-rinses for the prevention of chemotherapy-induced oral mucositis in children:a systematic review. Iranian J Pediatr Hematol Oncol 2015;5:106–12.
  • 7. Spivakovsky S. Low level laser therapy may reduce risk of oral mucositis. Evidence-Based Dentistry 2015;16:49.
  • 8. Bezinelli LM, de Paula Eduardo F, da Graça Lopes RM, et al. Costeffectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation. Hematologic Oncol 2014;32:31–9.
  • 9. Sung L, Robinson P, Treister N, et al. Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation. BMJ Support Palliat Care 2017;7:7–16.
  • 10.He M, Zhang B, Shen N, et al. A systematic review and meta-analysis of the effect of low-level laser therapy (LLLT) on chemotherapy-induced oral mucositis in pediatric and young patients. Eur J Pediatr 2018;177:7–17.
  • 11. Clarkson JE, Worthington HV, Furness S, et al. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev 2010;8:CD001973.
  • 12. Vayne-Bossert P, Escher M, de Vautibault CG, et al. Effect of Topical Morphine (Mouthwash) on Oral Pain Due to Chemotherapy- and/or Radiotherapy-Induced Mucositis:A Randomized Double-Blinded Study. J Palliative Med 2010;13:125–8.
  • 13. Prakash S, Meena JP, Gupta AK, et al. Ketamine mouthwash versus placebo in the treatment of severe oral mucositis pain in children with cancer:A randomized double-blind placebo-controlled trial. Pediatr Blood Cancer 2020;67:1–9.
  • 14. Kuiken NSS, Rings EHHM, van den Heuvel-Eibrink MM, et al. Feeding strategies in pediatric cancer patients with gastrointestinal mucositis:a multicenter prospective observational study and international survey. Support Care Cancer 2017;25:3075–83.

ÇOCUK KANSER HASTALARINDA AĞIZ BAKIM PROTOKOLLERİNİN MUKOZİTE ETKİSİ: RANDOMİZE KONTROLLÜ BİR ÇALIŞMA

Yıl 2024, Cilt: 14 Sayı: 4, 180 - 188, 31.07.2024
https://doi.org/10.16899/jcm.1475337

Öz

Amaç: Standart ağız bakım protokolleri mukozit insidansını azaltabilir. Bu çalışmada, pediatrik kanser hastalarında sodyum bikarbonat veya salin içeren "Ağız Bakım Protokolü"nün mukozit gelişimi, derecesi ve süresi üzerine etkisinin değerlendirilmesi amaçlandı.

Yöntemler: Bu çalışma kör, paralel deneme tasarımına sahip, randomize kontrollü bir çalışmadır. Çocuk Hematoloji ve Onkoloji Ünitesinde üç günden fazla yatarak kemoterapi tedavisi gören hastalar (n=43) çalışmaya dahil edildi. Kontrol grubundaki hastalara (n=22) salin ile ağız bakım protokolü, çalışma grubundaki hastalara (n=21) ise sodyum bikarbonat ile ağız bakım protokolü verildi. Birincil sonuç mukozit gelişimiydi. İkincil sonuçlar mukozit derecesi, mukozit gelişimi sırasındaki hasta verileri ve mukozitin süresiydi. Çalışma ve kontrol grubundaki hastaların özellikleri ile mukoziti olan ve olmayan hastaların verileri Fisher'in kesin testi, t-testi ve ki-kare analizi ile karşılaştırıldı.

Bulgular: Çalışma ve kontrol grupları arasında yaş ortalaması, cinsiyet, tanı, relaps durumu, tedavi evresi, risk grubu ve tedavi protokolleri açısından istatistiksel olarak anlamlı fark bulunamadı. Kontrol grubundaki hastaların %18,2'sinde, çalışma grubundaki hastaların ise %9,5'inde mukozit gelişti. Mukozit gelişimi, derecesi ve süresi açısından istatistiksel olarak anlamlı fark bulunamadı.

Sonuç: Sodyum bikarbonat içeren ağız bakım protokolü pediatrik kanser hastalarında mukozitin önlenmesinde kullanılabilir. ClinicalTrials.gov Tanımlayıcı: NCTXXX.

Kaynakça

  • 1. Braguês R, Marvão MF, Correia P, Silva RM. Oral Mucositis Management in Children under Cancer Treatment: A Systematic Review. Cancers. 2024;16(8):1548.
  • 2. Anwer DJ, Ahmed K, Abdulla B. The Effect of Oral-care Program and Mouthwash Use as a Prophylaxis in Minimizing the Incidence of Chemotherapy-Induced Oral Mucositis of Pediatric and Adolescent Cancer Patients. Sulaimani Dent J 2020;7:16–24.
  • 3. Perry AD, Iida H, Patton LL, Wilder RS. Knowledge, Perceived Ability and Practice Behaviors Regarding Oral Health among Pediatric Hematology and Oncology Nurses. J Dent Hygiene, 2015;89:219–28.
  • 4. Spurr S, Bally J, Ogenchuk M. Integrating oral health into pediatric nursing practice:Caring for kids where they live. J Spec Pediatr Nurs 2015;20:105–14.
  • 5. El Bousaadani A, Eljahd L, Abada R, et al. Prevention and treatment of mucositis in children with oral cancers:Practical recommendations. Cancer Radiother 2016;20:226–30.
  • 6. Hashemi A, Bahrololoumi Z, Khaksar Y, et al. Mouth-rinses for the prevention of chemotherapy-induced oral mucositis in children:a systematic review. Iranian J Pediatr Hematol Oncol 2015;5:106–12.
  • 7. Spivakovsky S. Low level laser therapy may reduce risk of oral mucositis. Evidence-Based Dentistry 2015;16:49.
  • 8. Bezinelli LM, de Paula Eduardo F, da Graça Lopes RM, et al. Costeffectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation. Hematologic Oncol 2014;32:31–9.
  • 9. Sung L, Robinson P, Treister N, et al. Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation. BMJ Support Palliat Care 2017;7:7–16.
  • 10.He M, Zhang B, Shen N, et al. A systematic review and meta-analysis of the effect of low-level laser therapy (LLLT) on chemotherapy-induced oral mucositis in pediatric and young patients. Eur J Pediatr 2018;177:7–17.
  • 11. Clarkson JE, Worthington HV, Furness S, et al. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev 2010;8:CD001973.
  • 12. Vayne-Bossert P, Escher M, de Vautibault CG, et al. Effect of Topical Morphine (Mouthwash) on Oral Pain Due to Chemotherapy- and/or Radiotherapy-Induced Mucositis:A Randomized Double-Blinded Study. J Palliative Med 2010;13:125–8.
  • 13. Prakash S, Meena JP, Gupta AK, et al. Ketamine mouthwash versus placebo in the treatment of severe oral mucositis pain in children with cancer:A randomized double-blind placebo-controlled trial. Pediatr Blood Cancer 2020;67:1–9.
  • 14. Kuiken NSS, Rings EHHM, van den Heuvel-Eibrink MM, et al. Feeding strategies in pediatric cancer patients with gastrointestinal mucositis:a multicenter prospective observational study and international survey. Support Care Cancer 2017;25:3075–83.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Hematolojisi ve Onkolojisi
Bölüm Orjinal Araştırma
Yazarlar

Gülçin Özalp Gerçeker 0000-0002-2229-616X

Büşra Güliz Yıldırım 0000-0001-6212-2810

Ayşe Önal 0000-0001-7401-9191

Murat Bektaş 0000-0003-3327-8204

Asım Leblebici 0000-0002-5197-6631

Hale Ören 0000-0001-5760-8007

Nur Olgun 0000-0001-9591-0207

Yayımlanma Tarihi 31 Temmuz 2024
Gönderilme Tarihi 15 Mayıs 2024
Kabul Tarihi 27 Haziran 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 14 Sayı: 4

Kaynak Göster

AMA Özalp Gerçeker G, Yıldırım BG, Önal A, Bektaş M, Leblebici A, Ören H, Olgun N. The Effect of Oral Care Protocols on Mucositis in Pediatric Cancer Patients: A Randomized Controlled Trial. J Contemp Med. Temmuz 2024;14(4):180-188. doi:10.16899/jcm.1475337