Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):217-26. doi: 10.1016/j.tripleo.2008.04.003. Epub 2008 Jun 13.

Abstract

Objective: The aim of the study was to examine oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy (CT) in breast cancer patients during and 1 year after treatment.

Study design: Forty-five consecutive breast cancer patients, eligible for adjuvant CT with cyclophosphamide, epirubicin or methotrexate, and 5-fluorouracil were followed before, during, 6 months and 1 year after CT and were compared to a control group of 31 breast cancer patients not receiving adjuvant CT.

Results: During CT, oral mucosal lesions developed including erythema (n = 10, 22%) and ulceration (n = 7, 16%). Five patients (11%) were diagnosed with oral candidosis. Scores of dental bacterial plaque and gingival inflammation increased during CT and the oral microbial composition changed towards a more acidophilic flora. Taste disturbances were experienced by 84% (n = 38) of the patients in the CT group.

Conclusion: In breast cancer patients, moderate-intensive adjuvant CT caused oral mucosal lesions, oral candidosis, taste disturbances and a more acidophilic oral microflora. These adverse effects were temporary and the majority of the patients were mildly affected.

MeSH terms

  • Adult
  • Aged
  • Antibiotics, Antineoplastic / administration & dosage
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / surgery
  • Candidiasis, Oral / chemically induced
  • Chemotherapy, Adjuvant
  • Cyclophosphamide / administration & dosage
  • Dental Plaque Index
  • Epirubicin / administration & dosage
  • Female
  • Fluorouracil / administration & dosage
  • Follow-Up Studies
  • Gingivitis / chemically induced
  • Humans
  • Lactobacillus / drug effects
  • Methotrexate / administration & dosage
  • Middle Aged
  • Mouth / drug effects
  • Mouth / microbiology*
  • Mouth Diseases / chemically induced*
  • Prospective Studies
  • Purpura / chemically induced
  • Streptococcus mutans / drug effects
  • Taste Disorders / chemically induced*

Substances

  • Antibiotics, Antineoplastic
  • Antimetabolites, Antineoplastic
  • Antineoplastic Agents, Alkylating
  • Epirubicin
  • Cyclophosphamide
  • Fluorouracil
  • Methotrexate