Oral candidiasis in patients receiving radiation therapy for head and neck cancer.
OBJECTIVE
To investigate oral candidiasis in patients with head and neck cancer before, during, and after radiation therapy, and to explore its association with clinical oropharyngeal symptoms.


METHODS
A cohort study.


METHODS
University hospital.


METHODS
Subjects who received radiation therapy (RT) for the treatment of head and neck cancer were divided into two groups: an oral cavity irradiated group (OIRR group, n = 29) and an oral cavity nonirradiated group (ONIRR group, n = 17). A control group consisted of 18 healthy subjects. Patients were examined for signs of oral candidiasis before, during, immediately after, and one month after RT. Mouth and throat soreness (MTS), dysphagia, and xerostomia were evaluated by self-reported questionnaires, and associations between oral candidiasis and these symptoms were analyzed.


RESULTS
The incidence of oral candidiasis during RT was significantly higher in the OIRR group (55.2%) than in the ONIRR group (11.8%). Similarly, the occurrence of xerostomia during RT was significantly higher in the OIRR group (86.2%) than in the ONIRR group (52.9%). In the OIRR group, the mean MTS score at the 20th fraction of RT was significantly higher in patients with candidiasis (mean +/- SD, 5.8 +/- 2.1) than in those with RT-induced mucositis without candidiasis (3.7 +/- 2.0). In the OIRR group, 65.2 percent of patients who experienced dysphagia developed oral candidiasis, compared with only 10 percent in the ONIRR group.


CONCLUSIONS
Oral candidiasis concurrent with oral mucositis due to RT may increase oropharyngeal discomfort during RT.
Deng
Zeyi
Z
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan. jordandzy@hotmail.com
Kiyuna
Asanori
A
Hasegawa
Masahiro
M
Nakasone
Isamu
I
Hosokawa
Atsushi
A
Suzuki
Mikio
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002180:Candidiasis, Oral / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013280:Stomatitis / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D014987:Xerostomia / Q000453:epidemiology / Q000209:etiology