Oral candidiasis in head and neck cancer patients receiving radiotherapy with amifostine cytoprotection

Quantifying Radioxerostomia: Salivary Flow Rate, Examiner’s Score, and Quality of Life Questionnaire

“…The higher value for dyspnea, as observed in our data, suggests correlations of xerostomia with a wider spectrum of problems, as found for pain and emotion by other authors [33]. Regarding salivary functions, some authors even suggest oral candidiasis, a surrogate for the immunoprotection of saliva, as an objective, early endpoint for radioprotective effects on salivary glands [40]. As reported by other groups using the EORTC QoL instrument, the lack of correlation between xerostomia scales (dry mouth, sticky saliva, trismus, problems with teeth, trouble eating) and global QoL or function scores has to be interpreted using larger patient samples [23].…”

Systematic review of amifostine for the management of oral mucositis in cancer patients

“…This might possibly prevent the up-regulation of inflammatory pathways related to cancer therapy toxicity and, thus, may allow compliance with the planned treatment regimens while preserving the patient's quality of life. Amifostine, administered intravenously, has been shown to reduce the incidence of acute and late xerostomia in head and neck cancer patients who receive radiotherapy, with or without chemotherapy [4][5][6][7][8][9][10][11][12][13]. The American Society of Clinical Oncology has recommended that the cytoprotective effect of amifostine "may be considered" for the prevention of cisplatin-associated nephrotoxicity, for the reduction of grade 3-4 neutropenia and to decrease acute and late xerostomia with fractionated radiotherapy for head and neck cancer [14,15].…”

“…With regard to oral mucositis, the literature is conflicting with some studies suggesting amifostine to be beneficial in prevention of oral mucositis [4,5,7,11,13,[16][17][18][19][20][21][22][23][24] and some studies suggesting that amifostine does not reduce mucositis prevalence or severity [6,8,10,[25][26][27][28][29][30][31]. Stokman et al performed a meta-analysis of seven studies and reported a positive preventive effect of amifostine on severe oral mucositis [32].…”

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

“…The most common infection of the oral mucosa during radiotherapy is oral candidiasis [4,6,10,14,15,17], whereas herpetic infection complicating mucositis has been documented in a few cases [14]. Candidiasis may be caused by different Candida species.…”

“…The differential diagnosis of the infection from the grades 2, 3, and 4 ulcerative/pseudomembrane mucositis, as several authors have stated [2,6,14,15], is difficult or impossible.…”