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Patterns of sore mouth in outpatients with cancer receiving chemotherapy

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Abstract

Goals

The aims of this secondary data analysis were to (a) categorize patterns in the development, duration, intensity, and resolution of sore mouth (which can be considered a proxy for oral mucositis) severity and distress over two cycles of chemotherapy in cancer outpatients and (b) examine the relationship of demographic (age, gender, marital status, and educational level) and disease characteristics (type of cancer and type of chemotherapy) to specific patterns of sore mouth (SM).

Materials and methods

Visual graphical analysis (VGA) was applied to identify individual patterns of SM severity and distress in 51 outpatients receiving chemotherapy who provided daily reports of sore mouth using a computerized interactive voice response system. The majority were female (n = 41, 8%) with a mean age of 53 (SD = 8.35). Most had breast cancer (68%), and one third received chemotherapy with adriamycin and cyclophosphamide (AC). VGA is a technique in which graphs of individual patients’ symptoms are coded for specific individual or group profiles.

Main results

Seven distinct patterns were identified based on variability in onset, duration, and intensity (degree of severity or distress). Chemotherapy agents were significantly associated with patterns of SM. The AC regimen was significantly associated with late onset; however, the intensity did not last long. In contrast, patients receiving R-CHOP were significantly more likely to experience duration intensity (SM after day 15 and a score equal to or greater than a 5 on a 1–10 scale).

Conclusions

VGA revealed symptom patterns often hidden in traditional analysis. Understanding individual variability is important to the design and implementation of future intervention research and clinical care.

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Acknowledgments

This research was supported in part by the American Cancer Society Doctoral Scholarship #DSCN-03-203-01 and National Cancer Institute, R25 CA093831. The parent study “Telephone-Linked Care for Symptom Management” (K. Mooney, PI) 1 R01 CA89474, funded) was funded by the NCI.

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Authors and Affiliations

  1. School Of Nursing, College of Health Sciences, University of Delaware, McDowell Hall, Newark, DE, 19716, USA

    Carlton G. Brown

  2. College of Nursing, University of Utah, 10 South 2000, East Salt Lake City, UT, 84112, USA

    Susan L. Beck, William N. Dudley & Kathleen H. Mooney

  3. Neag Comprehensive Cancer Center, University of Connecticut Health Center, University of Connecticut, Farmington Avenue, Farmington, CT, 06030, USA

    Douglas E. Peterson

  4. School of Nursing, University of Maryland, 655 West Lombard Street, Room 325B, Baltimore, MD, 21201, USA

    Deborah B. McGuire

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  1. Carlton G. Brown
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  2. Susan L. Beck
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  3. Douglas E. Peterson
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  4. Deborah B. McGuire
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  5. William N. Dudley
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  6. Kathleen H. Mooney
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Correspondence to Carlton G. Brown.

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Brown, C.G., Beck, S.L., Peterson, D.E. et al. Patterns of sore mouth in outpatients with cancer receiving chemotherapy. Support Care Cancer 17, 413–428 (2009). https://doi.org/10.1007/s00520-008-0509-y

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  • DOI: https://doi.org/10.1007/s00520-008-0509-y

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