Effect of fluconazole antifungal prophylaxis on oral mucositis in head and neck cancer patients receiving radiotherapy |
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| Authors: | 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 |
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| Affiliation: | (1) Department of Oral Pathology and Surgery, Dental Oncology Unit, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece;(2) Mycology Reference Laboratory, Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 115 28 Athens, Greece;(3) 2nd Radiotherapy Department, O Aghios Savas Hospital, Alexandras Avenue 171, 115 22 Athens, Greece;(4) Department of Radiotherapy, School of Medicine, Aretaieion University Hospital, National and Kapodistrian University of Athens, Vas Sofias 76, 115 28 Athens, Greece;(5) Radiation Department, Athinaion Hospital, Euromedica, Kononos 123, Vironas, Athens, Greece;(6) Radiation Oncology Department of Hygeia Hospital, Kifisias Avenue and Erythrou Stavrou 4, Maroussi, 151 23 Athens, Greece;(7) Department of Maxillofacial Surgery, O Aghios Savas Hospital, Alexandras Avenue 171, 115 22 Athens, Greece;(8) Bouboulinas 41, N. Psyhico, 154 51 Athens, Greece |
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| 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. |
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| Keywords: | Antifungal prophylaxis Fluconazole Oral candidiasis Oral mucositis Radiotherapy |
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