Impact of Fluconazole Prophylaxis on Oral Mucositis and Nutrition Status of Head and Neck Cancer Patients Receiving Radiotherapy
Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 2
Abstract
Background: Oral mucositis is one of the most significant toxicities associated with head and neck radiotherapy. Radiation related mucosal barrier injury allows for microbial colonization and infection, leading, in turn, to amplification of tissue injury. Aim of work: To evaluate the effect of fluconazole antifungal prophylaxis on the incidence and severity of oral mucositis induced by radiation therapy in patients with head and neck cancer and to determine the impact of this prophylaxis on their nutritional status. Patients and methods: Eighty patients with head and neck cancer, eligible to receive radiotherapy were categorized into two groups each of 40 patients. Study group received oral fluconazole 100mg/day starting from the sixth irradiation session throughout treatment course as compared to control group with similar radiotherapy characteristics who didn’t receive antifungal prophylaxis. Incidence and severity of oral mucositis and impact of oral mucositis on nutritional status (using malnutrition score) of this patient population were evaluated. Results: Incidence of clinical oral mucositis wasnon-significantly lower in patients who received fluconazole antifungal prophylaxis at the end of radiation therapy (90% vs 100%). However fluconazole prophylaxis showed a very high significant reduction of the severity of mucositis (P=0.00).High incidence of oral mucositis in both groups negatively affected patient’s nutritional status, however less significantly in patients who received fluconazole prophylaxis. Conclusions: Although fluconazole prophylaxis showed no significant effect on the prevention of oral mucositis, it significantly reduced its severity and showed significant improvement in patients’ nutritional status.
Authors and Affiliations
Manal Hamed El-Hamamsy
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