Parâmetros microbiológicos e salivares estão Relacionados com a mucosite oral grave em crianças e Adolescentes em quimioterapia?

Abstract

Oral mucositis is the main comorbidity in children and adolescents during chemotherapy. However, to date, the pathogenesis of this condition is not well understood. Studies point to genetic, microbiological and salivary variables as risk factors for mucositis. In this perspective, the objective was to longitudinally evaluate the salivary and microbiological parameters and its association with severe oral mucositis (MOG) in pediatric oncology patients. A field and laboratory study, approved by CEP / UFPB (CAAE: 45800415.7.0000.5188) and developed at Hospital Napoleão Laureano, João Pessoa / PB, was carried out. Patients aged 0 to 19 years (n = 26), with diagnosis of malignant neoplasia, were included in the study and were followed before (T1) and after two (T2), five (T3) and ten (T4) weeks of therapy induction. For each period, the oral mucosa was examined by the modified Oral Assessment Guide (OAG) by calibrated examiners (ĸ> 0.70). The microbiological and salivary analysis was done by collections of non-stimulated saliva performed in the morning and under the same conditions. Socioeconomic and treatment data were collected from medical records. Non-stimulated salivary flow (FSNE), salivary viscosity (VS), saliva pH, total Streptococcus (ET) and Streptococcus mutans (EGM) were determined. The data were analyzed descriptively and inferentially by the Chi- Square, Wilcoxon and Spearman correlation (α = 5%). The patients evaluated were predominantly female (n = 15, 57.7%); adolescents (n = 15, 57.7%); (n = 14, 53.8%), from the interior of Paraíba (n = 13; 50.0%) and hematological tumors (n = 21, 80.8%). MOG was present in all evaluated periods, being more frequent in T3 (n = 7, 28.6%). The oral mucosa and the palate, when ulcerated, were OAG sites associated with MOG in T2, T3 and T4 (p <0.05). In T2 and T3 the chemotherapeutics of the natural product class, and in T4, the antimetabolics were the most administered. Chemotherapy regimen with agent of the miscellaneous group were associated with absence or mild pictures of mucositis in T3 (p <0.05). Antimetabolic agents and natural products were associated, respectively, with the increase and reduction of FSNE in T3 (p <0.05). The other variables: pH, VS, ET and EGM were not modified by the chemotherapy institution (p> 0.05). They were positively correlated to MOG and time, ET and EGM, and SV and EGM (p <0.05). It was concluded that salivary and microbiological variables did not influence the occurrence of MOG in children and adolescents with cancer undergoing chemotherapy.