Mucosite oral e qualidade de vida: compreendendo os impactos na perspectiva de pacientes em tratamento oncológico

Abstract

Oral mucositis (OM) is one of the most frequent and debilitating complications of oncological treatment, which can lead to pain, ulcerations, dysphagia, and malnutrition, and may result in therapy interruption, profoundly affecting patients’ quality of life (QoL). Despite its clinical relevance, measuring this impact faces methodological challenges, particularly regarding the choice of assessment instruments. While generic instruments have limited sensitivity, disease-specific tools are more effective in capturing the patient’s perspective and the true extent of their suffering. This study aimed to understand the impact of OM on the QoL of cancer patients through two concomitant and complementary methodological approaches: a scoping review and a cross-sectional study. The scoping review, conducted in accordance with PRISMA-ScR guidelines, included searches across six databases (PubMed, Scopus, Embase, Web of Science, SciELO, and Lilacs), resulting in 35 studies analyzed. An important methodological gap was identified: the predominance of generic instruments. In contrast, studies that employed specific tools, such as the Oral Mucositis Quality of Life (OMQoL), were able to capture the impact of OM on QoL more accurately. The cross-sectional quantitative study was conducted with 56 adult patients undergoing antineoplastic treatment at the Hospital das Clínicas of the Federal University of Minas Gerais (HC-UFMG). OM severity was classified according to the World Health Organization (WHO) scale, and QoL impact was assessed using the OMQoL, in its shortened and culturally adapted version for Brazil. Associations were investigated through nonparametric statistical tests (Kruskal-Wallis and Mann-Whitney). The results revealed that OM was present in 80.4% of participants, with grade 3 being the most prevalent (41.1%), indicating moderate to severe cases. A statistically significant association (p < 0.001) was found between higher OM severity and worse QoL scores across all OMQoL domains (Symptoms, Diet, Social Function, and Swallowing). The mean total OMQoL score progressively increased from 24.36 (grade 0) to 48.67 (grade 4), demonstrating a marked and gradual deterioration in QoL. In conclusion, OM is a key clinical factor in the worsening of QoL among cancer patients, with severity being the main predictor of perceived impact. This dissertation provides a dual contribution: it presents robust primary data on the reality of a public reference hospital in Brazil and maps the scientific landscape, confirming the importance of using disease-specific instruments. The application of the OMQoL in clinical practice represents a fundamental tool for sensitive and continuous monitoring, intervention assessment, and improvement of multiprofessional care, strengthening the role of Dentistry within oncology teams and contributing to the advancement of healthcare practices.