Predictive factors for oropharyngeal mycosis during radiochemotherapy for head and neck carcinoma and consequences on treatment duration. Results of mycosis in radiotherapy (MIR): a prospective longitudinal study.
OBJECTIVE
Oropharyngeal mycosis (OPM) is a complication of radiotherapy (RT) treatments for head and neck (H&N) cancer, worsening mucositis and dysphagia, causing treatment interruptions and increasing overall treatment time. Prophylaxis with antifungals is expensive. Better patient selection through the analysis of prognostic factors should improve treatment efficacy and reduce costs.


METHODS
A multicentre, prospective, controlled longitudinal study, with ethics committee approval, examined H&N cancer patients who were candidates for curative treatments with radio-chemotherapy. Patients were divided in groups according to OPM appearance: before the starting of RT (cases), during RT (new cases) and never (no cases).


RESULTS
Of 410 evaluable patients, 20 were existing cases, 201 new cases and 189 did not report OPM. In our study OPM appears in 42.4% of people >70years and in 58.2% of younger individuals (p=0.0042), and in 68.6% of women versus 50.8% of men (p=0.0069). Mucositis and dysphagia were higher and salivation reduced among people with OPM (p<0.0000). Patients with OPM had longer hospitalization (p=0.0002) and longer (>12days) treatment interruptions (p=0.0288).


CONCLUSIONS
Patients with OPM had higher toxicity and a greater number of long treatment interruptions. Analyses of prognostic factors can help clinicians understand OPM distribution and select patients with the highest probability of OPM for antifungal prophylaxis.
Department of Radiotherapy, Ospedale dell'Angelo, Mestre (VE), Italy. Electronic address: mario.busetto@ulss12.ve.it.
Mario
M
Busetto
Vincenzo
V
Fusco
Franco
F
Corbella
Mario
M
Bolzan
Giovanni
G
Pavanato
Bartolomea
B
Bonetti
Francesca
F
Maggio
Marco
M
Orsatti
Costantino
C
De Renzis
Giovanni
G
Mandoliti
Guido
G
Sotti
Michela Buglione
MB
di Monale E Bastia
Giacomo
G
Turcato
Sara
S
Colombo
Stefano Maria
SM
Magrini
Rosa Bianca
RB
Guglielmi
Luca
L
Cionini
Paolo
P
Montemaggi
Gino
G
Panizzoni
Paolo
P
Delia
Francesco
F
Sciumé
Giovanni
G
Castaldo
Francesco
F
Matteucci
Lucio
L
Loreggian
Guido
G
Sansotta
Luciana
L
Lastrucci
D000293:Adolescent; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology*; D009960:Oropharynx / Q000382:microbiology; D010608:Pharyngeal Diseases / Q000209:etiology*; D011446:Prospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck
Head & Neck; Mycosis; Oropharynx; Predictive factors