Prevalence and predictors of oral mucositis in patients undergoing radiotherapy for head and neck carcinomas at the Kenyatta National Hospital

Abstract

Background Oral mucositis is a common and significant acute complication of radiotherapy and chemotherapy but there is limited data on its overall impact, prevalence and risk factors in our setting. Objective To determine the prevalence and predictors of oral mucositis in patients with head and neck carcinomas, undergoing radiotherapy at the Kenyatta National Hospital. Study Setting and Population The study was carried out at the Kenyatta National Hospital radiotherapy clinic, the ENT (Ear, Nose and Throat) ward and the adult oncology ward. The study sample consisted of 72 patients undergoing radiotherapy for head and neck carcinomas. Study Design and Methodology This was a prospective cross sectional study. Pre-treatment demographic and clinical data were collected and the patient’s oral cavity was also examined. Participants were re-evaluated at the end of 2, 4 and 6 weeks, during which any oral lesions were graded using the NCI-CTC (National Cancer Institute – Common Terminology Criteria) grading scale. Results All the 72(100%) patients developed mucositis by the second week of treatment. A total of 51 patients (70.8%) developed grade 3 mucositis by the 2nd week of treatment. Patients with oral cavity tumours had the highest risk of developing severe mucositis (p value 0.001), in contrast patients with laryngeal carcinomas had the lowest risk of developing severe mucositis (p <0.001). The presence of oral ulceration pre-treatment was found to increase the risk of developing severe mucositis ( p value 0.005) and concurrent chemotherapy increased the odds of developing severe mucositis by 2½ times. Conclusion and Recommendations The prevalence of mucositis is high in head and neck carcinoma patients undergoing radiotherapy at KNH. There is need for increasing interventions in management of mucositis, to improve the quality of care offered in our set up.