Impact of structured oral care strategies on oral mucositis in patients receiving 5-fluorouracil: a retrospective cohort study.

PURPOSE: Oral mucositis (OM) is a frequent and debilitating complication of 5-fluorouracil (5-FU)-based chemotherapy, compromising patients' quality of life and treatment adherence. This study aimed to evaluate the impact of a structured oral care strategy (OCS), including photobiomodulation (PBM), on the severity, onset, and duration of OM in patients with solid tumors receiving 5-FU-based regimens.

METHODS

This single-center study included 69 patients treated between 2020 and 2022 and was retrospectively registered (Ethics Committee approval No. 5.089.912/2021). All participants received standardized OCS before and during chemotherapy, consisting of dental examination, oral hygiene instructions, infection control measures, and PBM. PBM was delivered once daily during the first two days of each 5-FU chemotherapy cycle. Associations were analyzed using Chi-square tests and odds ratios.

RESULTS

All patients developed OM, predominantly grade 1 (40.6%) or grade 2 (52.2%), while only 7.2% experienced grade 3 lesions. Two PBM sessions were significantly associated with reduced onset, severity, and duration of OM, particularly among patients receiving FOLFIRINOX, for whom the risk of OM decreased 9.1-fold, and among neutropenic patients (p = 0.042). Conversely, the FOLFOX regimen was associated with earlier onset (p = 0.004) and greater severity (p = 0.026); however, two PBM sessions remained beneficial, reducing OM risk 1.35-fold.

CONCLUSION

Structured OCS incorporating PBM appears to be an effective, non-invasive approach to mitigate OM severity, onset, and duration in patients undergoing 5-FU-based chemotherapy. These findings support integrating dental care and PBM into routine oncology protocols. Prospective multicenter studies are warranted to validate and standardize this strategy.