2097P - Incidence, risk factors (RFs) and management of oral mucositis (OM) in patients (pts) treated with a fluoropyrimidines (FP)-based therapy (tp): A retrospective, monocentric experience

Background

OM is one of the main adverse events during chemotherapy, affecting around 40% of pts; it is characterized by an inflammation and ulceration of the oral mucous membranes that can lead to oral pain, impaired nutritional intake, local or systemic infections and lower quality of life. Only few strategies are available for its prevention and management. FP-based tp can cause OM due to their cytotoxic effect on mucosal cells inducing DNA double strand brakes and ROS production, empowered by TNF-alfa release. In our retrospective monocentric study we evaluated clinical and hematological RFs which could help us to identify early those patients who might benefit the most from a preventive strategy.

Methods

We evaluated incidence, management and possible RFs for OM (such as diabetes, smoke, BMI and blood inflammation markers) on 174 pts treated with a FP-based tp during a typical month in our DH. Statistical analysis has been conducted using Chi-square test and Fisher’s exact test. Pts have been informed about risk of developing OM and we subsequently managed the symptom on the basis of its severity according to CTCAE.

Results

48 pts developed OM. We found a higher OM incidence in smoker pts (60.5% vs 21.4% in non smoker, p<0.0001) and in overweight pts (39.7% vs 24.1% in pts with normal weight, p=0.0381). We also demonstrated a correlation between a higher OM severity and diabetes diagnosis (71% vs 29.8% in non diabetic pts, p=0.0330). No statistically significant correlation emerged between OM incidence/severity and any of the blood values tested (blood cells values, NLR, PLR, creatinine). 20 pts had ≥G2 OM and received local and/or systemic therapies, while 3 pts needed a treatment suspension. Median time to resolution was 28 days. 6 pts still had OM of various severity grade at the time of our analysis.

Conclusions

Smoke and overweight could be RFs for OM incidence of any grade during a FP-based treatment, while a diabetes diagnosis seemed to be related with a higher severity of OM, but not with its incidence. In view of the above, it might be useful to recommend accurate oral hygiene and a preventive strategy in accordance with MASCC guidelines in these subgroups of pts.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.