A Retrospective Cohort Study of Acute Radiotherapy Induced Mucositis, Radiodermatitis and Dental Disorders in Brazilian Head and Neck Cancer Patients

Tatiane Sorribas da Silva; Denis Oliveira dos  Santos; Célia Soares; Carla Daruich de Souza

doi:10.32635/2176-9745.RBC.2026v72n4.5719

Autores/as

Tatiane Sorribas da Silva Hospital Santa Marcelina. São Paulo (SP), Brasil. Instituto de Pesquisas Energéticas e Nucleares (IPEN). São Paulo (SP), Brasil. https://orcid.org/0009-0003-1776-6985
Denis Oliveira dos Santos Hospital Santa Marcelina. São Paulo (SP), Brasil. https://orcid.org/0009-0004-1279-2946
Célia Soares Hospital Santa Marcelina. São Paulo (SP), Brasil. https://orcid.org/0009-0001-7097-8800
Carla Daruich de Souza Instituto de Pesquisas Energéticas e Nucleares (IPEN). São Paulo (SP), Brasil. https://orcid.org/0000-0003-1335-8864

DOI:

https://doi.org/10.32635/2176-9745.RBC.2026v72n4.5719

Palabras clave:

Traumatismos por Radiación, Neoplasias de Cabeza y Cuello/complicaciones, Mucositis, Radiodermatitis/complicaciones, Toxicidad

Resumen

Introducción: La radioterapia para el cáncer de cabeza y cuello frecuentemente causa toxicidades agudas que comprometen la continuidad del tratamiento y la calidad de vida. Sin embargo, los datos integrados sobre la ocurrencia simultánea de mucositis, radiodermatitis y trastornos dentales en el Sistema Único de Salud (SUS) del Brasil siguen siendo escasos. Objetivo: Evaluar la incidencia y la gravedad de estos eventos adversos, además de identificar factores clínicos y de tratamiento asociados. Método: Estudio de cohorte retrospectivo en un único centro de radioterapia en São Paulo, Brasil, entre enero de 2021 y diciembre de 2024. Se utilizó regresión logística multivariada para identificar predictores independientes de mucositis severa y radiodermatitis, ajustando por edad, dosis de radiación y quimioterapia concomitante. Resultados: De los 180 pacientes evaluados, 146 fueron analizados (34 excluidos: 18 debido a historias clínicas incompletas, 10 debido a fallecimiento o abandono del tratamiento antes de la fracción 10 y seis debido a traslado). La mucositis ocurrió en 142 pacientes (97,3%; grado 3 en el 28,8%). La radiodermatitis ocurrió en 138 pacientes (94,5%; grado 3 en el 13,7%). Los trastornos dentales se documentaron en los 146 pacientes (100%), impulsados principalmente por hiposalivación (98,6%), caries por radiación (42,5%) y enfermedad periodontal (31,5%). En el análisis multivariado, la quimioterapia concomitante fue un predictor independiente de mucositis moderada a severa (OR=4,42; IC 95% 2,01–9,71; p<0,001), mientras que la dosis total de radiación ≥60 Gy se asoció independientemente con radiodermatitis severa (OR=3,08; IC 95% 1,28–7,41; p=0,012). Conclusión: La alta prevalencia y gravedad de las toxicidades agudas refuerzan la necesidad de un cuidado de soporte multidisciplinario estructurado. La tasa del 100% de trastornos dentales refleja la vulnerabilidad de la salud bucal de los pacientes atendidos en el SUS. Estos datos del mundo real ofrecen evidencias aplicables para protocolos clínicos y políticas públicas de salud.

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