Supportive Care in Cancer

, Volume 14, Issue 1, pp 44–51

Effect of fluconazole antifungal prophylaxis on oral mucositis in head and neck cancer patients receiving radiotherapy

  • Ourania Nicolatou-Galitis
  • Aristea Velegraki
  • Anastasia Sotiropoulou-Lontou
  • Konstantinos Dardoufas
  • Vassilis Kouloulias
  • Konstantinos Kyprianou
  • Georgia Kolitsi
  • Christos Skarleas
  • George Pissakas
  • Vassilis S. Papanicolaou
  • John Kouvaris
Original Article

Abstract

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.

Main results

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).

Conclusion

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.

Keywords

Antifungal prophylaxis Fluconazole Oral candidiasis Oral mucositis Radiotherapy 

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Ourania Nicolatou-Galitis
    • 1
    • 8
  • Aristea Velegraki
    • 2
  • Anastasia Sotiropoulou-Lontou
    • 3
  • Konstantinos Dardoufas
    • 4
  • Vassilis Kouloulias
    • 4
  • Konstantinos Kyprianou
    • 5
  • Georgia Kolitsi
    • 6
  • Christos Skarleas
    • 5
  • George Pissakas
    • 3
  • Vassilis S. Papanicolaou
    • 7
  • John Kouvaris
    • 4
  1. 1.Department of Oral Pathology and Surgery, Dental Oncology Unit, School of DentistryNational and Kapodistrian University of AthensAthensGreece
  2. 2.Mycology Reference Laboratory, Department of Microbiology, School of MedicineNational and Kapodistrian University of AthensAthensGreece
  3. 3.2nd Radiotherapy DepartmentO Aghios Savas HospitalAthensGreece
  4. 4.Department of Radiotherapy, School of Medicine, Aretaieion University HospitalNational and Kapodistrian University of AthensAthensGreece
  5. 5.Radiation Department, Athinaion HospitalEuromedicaAthensGreece
  6. 6.Radiation Oncology Department of Hygeia HospitalAthensGreece
  7. 7.Department of Maxillofacial SurgeryO Aghios Savas HospitalAthensGreece
  8. 8.AthensGreece

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