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

Authors
  • Nicolatou-Galitis, Ourania1,
  • Velegraki, Aristea2
  • Sotiropoulou-Lontou, Anastasia3
  • Dardoufas, Konstantinos4
  • Kouloulias, Vassilis4
  • Kyprianou, Konstantinos5
  • Kolitsi, Georgia6
  • Skarleas, Christos5
  • Pissakas, George3
  • Papanicolaou, Vassilis S.7
  • Kouvaris, John4
  • 1 National and Kapodistrian University of Athens, Department of Oral Pathology and Surgery, Dental Oncology Unit, School of Dentistry, Athens, Greece , Athens
  • 2 National and Kapodistrian University of Athens, Mycology Reference Laboratory, Department of Microbiology, School of Medicine, Mikras Asias 75, Goudi, Athens, 115 28, Greece , Athens
  • 3 O Aghios Savas Hospital, 2nd Radiotherapy Department, Alexandras Avenue 171, Athens, 115 22, Greece , Athens
  • 4 National and Kapodistrian University of Athens, Department of Radiotherapy, School of Medicine, Aretaieion University Hospital, Vas Sofias 76, Athens, 115 28, Greece , Athens
  • 5 Euromedica, Radiation Department, Athinaion Hospital, Kononos 123, Vironas, Athens, Greece , Athens
  • 6 Radiation Oncology Department of Hygeia Hospital, Kifisias Avenue and Erythrou Stavrou 4, Maroussi, Athens, 151 23, Greece , Athens
  • 7 O Aghios Savas Hospital, Department of Maxillofacial Surgery, Alexandras Avenue 171, Athens, 115 22, Greece , Athens
Type
Published Article
Journal
Supportive Care in Cancer
Publisher
Springer-Verlag
Publication Date
Jun 10, 2005
Volume
14
Issue
1
Pages
44–51
Identifiers
DOI: 10.1007/s00520-005-0835-2
Source
Springer Nature
Keywords
License
Yellow

Abstract

Goal of workThe 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 methodsSixty-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 resultsA 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).ConclusionFluconazole 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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