Effect of fluconazole antifungal prophylaxis on oral mucositis in head and neck cancer patients receiving radiotherapy
- First Online:
- 271 Downloads
Goal of work
The aim of the study is to evaluate the effect of fluconazole antifungal prophylaxis on the severity of mucositis in head and neck cancer patients receiving radiotherapy.
Patients and methods
Sixty-three patients, with malignant head and neck tumor, eligible to receive radiotherapy, entered the study. Thirty-four patients (group A) received 100 mg/day of fluconazole prophylaxis during radiotherapy and were compared with 29 patients, who received radiotherapy alone (group B). The two groups were similar in terms of patients and radiotherapy characteristics. Smear to test for Candida carriage was taken before and after radiotherapy. Oral candidiasis was diagnosed using the criteria described before. Oral mucositis was recorded according to EORTC/RTOG criteria.
A significant reduction of severe mucositis at the end of radiotherapy (14.7 vs 44.8%, p=0.018) and of interruptions (0 vs 17.2%, p=0.017) was observed in group A. Candidiasis was prevented (0 vs 34.5%, p=0.001), with a significant reduction of Candida carriage of 40.7% (p=0.001).
Fluconazole prophylaxis showed a significant beneficial impact on the severity of mucositis and on radiotherapy interruptions in this group of patients. The current study provides data on the build of a randomized controlled trial on the effect of fluconazole prophylaxis on treatment schedule and quality of life of the patients during head and neck radiotherapy.
KeywordsAntifungal prophylaxis Fluconazole Oral candidiasis Oral mucositis Radiotherapy
- 2.Chen TY, Webster JH (1974) Oral Monilia study on patients with head and neck cancer during radiotherapy. Cancer 34:246–249Google Scholar
- 5.El-Sayed S, Nabid A, Shelley W et al (2002) Prophylaxis of radiation-associated mucositis in conventionally treated patients with head and neck cancer: a double-blind, phase III, randomized, controlled trial evaluating the clinical efficacy of an antimicrobial lozenge using a validated mucositis scoring system. J Clin Oncol 20:3956–3963CrossRefPubMedGoogle Scholar
- 8.Kollia K, Arabatzis M, Kostoula O et al (2003) Clavispora (Candida) lusitaniae susceptibility profiles and genetic diversity in three tertiary hospitals (1998–2001). Int J Antimicrob Agents 22:455–457Google Scholar
- 13.Nicolatou O, Sotiropoulou-Lontou A, Skarlatos J, Kyprianou K, Kolitsi G, Dardoufas K (1998) A pilot study of the effect of granulocyte-macrophage colony-stimulating factor on oral mucositis in head and neck cancer patients during X-radiation therapy : a preliminary report. Int J Radiat Oncol Biol Phys 42:551–556CrossRefPubMedGoogle Scholar
- 14.Nicolatou-Galitis O, Dardoufas K, Markoulatos P et al (2001) Oral pseudomembranous candidiasis, herpes simplex virus-1 infection, and oral mucositis in head and neck cancer patients receiving radiotherapy and granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash. J Oral Pathol Med 30:471–480Google Scholar
- 19.Samaranayake LP, MacFarlane TW (1990) Oral candidosis. Wright, London, p 7Google Scholar