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


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.


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).


CONCLUSIONS
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.
Nicolatou-Galitis
Ourania
O
Department of Oral Pathology and Surgery, Dental Oncology Unit, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Velegraki
Aristea
A
Sotiropoulou-Lontou
Anastasia
A
Dardoufas
Konstantinos
K
Kouloulias
Vassilis
V
Kyprianou
Konstantinos
K
Kolitsi
Georgia
G
Skarleas
Christos
C
Pissakas
George
G
Papanicolaou
Vassilis S
VS
Kouvaris
John
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D002180:Candidiasis, Oral / Q000209:etiology / Q000517:prevention & control; D025141:Drug Resistance, Fungal; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D011878:Radiotherapy / Q000009:adverse effects; D012720:Severity of Illness Index; D013280:Stomatitis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control*; D016896:Treatment Outcome
D000935:Antifungal Agents; D015725:Fluconazole