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

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.

• 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
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 14 Issue 1 Pg. 44-51 (Jan 2006) ISSN: 0941-4355 [Print] Germany
• PMID: 15947956 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antifungal Agents
• Fluconazole

Topics

• Adult
• Aged
• Aged, 80 and over
• Antifungal Agents (therapeutic use)
• Candidiasis, Oral (etiology, prevention & control)
• Drug Resistance, Fungal
• Female
• Fluconazole (therapeutic use)
• Head and Neck Neoplasms (radiotherapy)
• Humans
• Incidence
• Male
• Middle Aged
• Radiation Injuries (etiology, pathology, prevention & control)
• Radiotherapy (adverse effects)
• Severity of Illness Index
• Stomatitis (etiology, pathology, prevention & control)
• Treatment Outcome