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Purpose <p>To evaluate the association between salivary inflammatory mediators and oral dryness during oral mucositis development in patients with cancer undergoing chemotherapy.</p> Methods <p>This prospective cohort study (time-stratified sampling) enrolled adult patients undergoing chemotherapy or chemoradiotherapy at Niigata University Medical and Dental Hospital (November 2021–August 2023). Sample size was determined a priori from a pilot study. Oral mucosal status was graded using the World Health Organization oral toxicity scale, and oral moisture was measured (dryness &lt; 28). Unstimulated whole saliva was analyzed for interleukins (IL)-1β, IL-6, IL-8, IL-10, IL-12p70, tumor necrosis factor (TNF), prostaglandin E2, and vascular endothelial growth factor via cytometric bead array and enzyme-linked immunosorbent assay. Clinical data included demographics, treatment, and days post-chemotherapy (0–7, 8–14, ≥ 15). TNF and IL-10 were independently associated with oral dryness; cutoffs were median levels in patients with grade 0 mucositis.</p> Results <p>Among 162 patients, 56 (34.6%) had oral dryness. Dryness was associated with higher neutrophil counts (median: 3.23 vs. 3.00 × 10<sup>3</sup>/µL; <i>p</i> = 0.04). C-reactive protein levels increased, and neutrophil counts decreased 8–14&#xa0;days post-chemotherapy. Multivariate analysis showed that TNF &gt; 4.7&#xa0;pg/mL was inversely associated (OR = 0.27; 95% CI = 0.11–0.69; <i>p</i> = 0.0058), whereas IL-10 &gt; 2.8&#xa0;pg/mL was positively associated (OR = 3.17; 95% CI = 1.30–7.75; <i>p</i> = 0.011) with dryness. Sampling at 8–14&#xa0;days post-chemotherapy predicted dryness (OR = 5.16; 95% CI = 1.32–20.09; <i>p</i> = 0.018).</p> Conclusions <p>Salivary TNF and IL-10 levels and sampling timing after CT were associated with oral dryness, suggesting temporal changes in salivary inflammatory mediators.</p>

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Relationship between salivary inflammatory mediators and oral dryness during chemotherapy in patients with cancer: a cohort study

  • 期刊论文

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  • 发表日期：

    2026年5月28日

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  • Anna Kiyomi,
  • Kensuke Yoshida,
  • Nana Okamoto,
  • Akira Kurokawa,
  • Chie Saito,
  • Hiroko Kanemaru,
  • Kei Tomihara,
  • Akitsugu Ohuchi,
  • Munetoshi Sugiura

摘要

Purpose

To evaluate the association between salivary inflammatory mediators and oral dryness during oral mucositis development in patients with cancer undergoing chemotherapy.

Methods

This prospective cohort study (time-stratified sampling) enrolled adult patients undergoing chemotherapy or chemoradiotherapy at Niigata University Medical and Dental Hospital (November 2021–August 2023). Sample size was determined a priori from a pilot study. Oral mucosal status was graded using the World Health Organization oral toxicity scale, and oral moisture was measured (dryness < 28). Unstimulated whole saliva was analyzed for interleukins (IL)-1β, IL-6, IL-8, IL-10, IL-12p70, tumor necrosis factor (TNF), prostaglandin E2, and vascular endothelial growth factor via cytometric bead array and enzyme-linked immunosorbent assay. Clinical data included demographics, treatment, and days post-chemotherapy (0–7, 8–14, ≥ 15). TNF and IL-10 were independently associated with oral dryness; cutoffs were median levels in patients with grade 0 mucositis.

Results

Among 162 patients, 56 (34.6%) had oral dryness. Dryness was associated with higher neutrophil counts (median: 3.23 vs. 3.00 × 103/µL; p = 0.04). C-reactive protein levels increased, and neutrophil counts decreased 8–14 days post-chemotherapy. Multivariate analysis showed that TNF > 4.7 pg/mL was inversely associated (OR = 0.27; 95% CI = 0.11–0.69; p = 0.0058), whereas IL-10 > 2.8 pg/mL was positively associated (OR = 3.17; 95% CI = 1.30–7.75; p = 0.011) with dryness. Sampling at 8–14 days post-chemotherapy predicted dryness (OR = 5.16; 95% CI = 1.32–20.09; p = 0.018).

Conclusions

Salivary TNF and IL-10 levels and sampling timing after CT were associated with oral dryness, suggesting temporal changes in salivary inflammatory mediators.