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.
Oral pseudomembranous candidiasis (OPC) was evaluated in 61 patients receiving head and neck radiotherapy (RT). Herpes simplex virus-1 (HSV-1) reactivation was also investigated in 14 patients. According to the agreed protocol, granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash was administered in 46 patients with radiation-induced ulcers. Candidiasis was diagnosed in 31 patients. Candida albicans was the most frequent isolate. Multiple Candida species were isolated from the lesions of four patients. Concurrent candidiasis and radiation-induced ulcers were observed in 17 patients. Viral culture and the polymerase chain reaction disclosed the presence of HSV-1 in five patients. Twenty of the 46 patients, with initial mucositis grade II and grade III, completed RT with mucositis grade I, indicating a beneficial effect of GMCSF mouthwash, although further controlled studies are necessary to verify that. In conclusion, OPC was an important infection in patients undergoing radiotherapy. The role of HSV-1 in oral mucositis during head and neck radiotherapy needs additional study.
Nicolatou-Galitis
O
O
Department of Oral Pathology and Surgery, School of Dentistry, University of Athens, Greece. nicolatou.galitis@mailcity.com
Dardoufas
K
K
Markoulatos
P
P
Sotiropoulou-Lontou
A
A
Kyprianou
K
K
Kolitsi
G
G
Pissakas
G
G
Skarleas
C
C
Kouloulias
V
V
Papanicolaou
V
V
Legakis
N J
NJ
Velegraki
A
A
D000230:Adenocarcinoma / Q000532:radiotherapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000145:classification; D002176:Candida albicans / Q000145:classification; D002180:Candidiasis, Oral / Q000188:drug therapy / Q000209:etiology*; D002277:Carcinoma / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D019583:Dose Fractionation, Radiation; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000254:growth & development; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D019226:Oral Ulcer / Q000188:drug therapy / Q000209:etiology; D012516:Osteosarcoma / Q000532:radiotherapy; D010865:Pilot Projects; D016133:Polymerase Chain Reaction; D011832:Radiation Injuries / Q000188:drug therapy / Q000209:etiology*; D013280:Stomatitis / Q000145:classification / Q000188:drug therapy / Q000209:etiology*; D013283:Stomatitis, Herpetic / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D014775:Virus Activation
D009067:Mouthwashes; D016178:Granulocyte-Macrophage Colony-Stimulating Factor