Real-World Insights into Chemotherapy-Induced Oral Mucositis: Clinical Burden, Management, and Predictive Factors

Abstract

BACKGROUND: Oral mucositis (OM) is a frequent and debilitating complication of chemotherapy, yet little is known about its burden and management in Sudan. Therefore, this study aimed to determine the prevalence, characteristics, management, and factors associated with OM. METHODS: A hospital-based cross-sectional study was conducted from April to June 2022 at Khartoum Oncology Hospital, Sudan, among chemotherapy patients, with OM severity graded per the World Health Organization criteria. The data were analyzed using SPSS version 27. RESULTS: Among the 340 patients, 258 (75.9%) were female, and 128 (37.6%) were aged 45-59 years. OM occurred in 127 (37.4%) patients, mostly with generalized lesions (96; 75.6%) and Grade 3 severity (76; 59.8%). Common complications included inability to eat (75; 59.1%) and taste changes (69; 54.3%). Only 36 (28.3%) patients received prescription medication, mainly miconazole gel (17; 47.2%); pain management was provided to 12 (11.5%) patients, and dental interventions were provided to two (0.6%) patients. In multivariable logistic regression, age (p = 0.035) and number of chemotherapy doses (p < 0.001) remained independent predictors, with lower odds for four to six doses (aOR (adjusted odds ratio) 0.152; 95% CI (confidence interval) 0.087-0.268), seven to ten doses (aOR 0.033; 95% CI 0.009-0.121), and more than ten doses (aOR 0.045; 95% CI 0.004-0.484) than for one to three doses. CONCLUSION: OM is moderately prevalent but often severe among Sudanese chemotherapy patients, with inadequate management and poor adherence to evidence-based practice. Implementing standardized oral care, clinician training, and patient education could reduce its burden and improve outcomes.