Chemotherapy-Induced Oral Changes in Cancer Patients: Prevalence, Types, and Risk Factors in a Nigerian Tertiary Health Facility.

Abstract

Background: Chemotherapy-induced oral changes are common complications after receiving chemotherapy. These complications are often not prioritized in clinical practice, particularly in resource-limited settings like Nigeria. However, they impact patients' quality of life and overall treatment outcomes This study determined the prevalence and types of chemotherapy-induced oral changes, the relationship between chemotherapeutic agents and oral changes, and the associated risk factors.

Methods: An analytical cross-sectional study with a convenience sampling method was designed at the Department of Oral Medicine and Oral Pathology, Obafemi Awolowo University, Osun State, Nigeria. The oral cavity of 82 patients aged 6 years and above who received cancer chemotherapy at the Paediatric Medicine, Haematology, and Surgical Units of the hospital were examined for pathologies associated with chemotherapy.

Results: Dysgeusia was present in 60 (73.17%), oral pain in 47 (57.32%), and oral mucositis (OM) in 44 (53.66%). Forty-two (95.45%) of the total 44 (100%) persons with OM complained of oral pain (p < 0.001), 41 (93.18%) had dysgeusia (p < 0.001), and 31 (70.45%) had fungal infection (p = 0.002). Methotrexate based regimens (MBR) were the most involved in oral changes, with 11 (91.67%) out of 12 having dysgeusia (p ≤ 0.001), 11 (91.67%) had oral pain(p=0.073), and 10 (83.33%) had mucositis (p=0.012). Age was not associated with oral changes (p =0.755), likewise cancer duration (p=0.483) and type of cancer (p=0.353). Multivariate analysis identified mucotoxic drugs (OR 3.6, CI 1.37, 9.19, p=0.009) and solid tumours (OR 2.5, CI 1.04, 6.02, p=0.040) as risk factors for severe OM.

Conclusion: Chemotherapy-induced oral changes are prevalent among patients with cancer. Mucotoxic agents and solid tumours are risk factors for severe mucositis. Early identification and prioritizing of oral care strategies are crucial to improving quality of life and treatment outcomes, particularly in resource-limited settings.