Fungal Infections during Radiation Therapy of Oral Cancers

Abstract

To study the prevalence of oral or oro-pharyngeal fungal infections during radiotherapy of oral cancer.120 patients receiving a 6-7 week course of radiation therapy alone (on Telecobalt machine) for treatments of oral cancer were enrolled in the study. Patients were clinically examined for signs of oral and oropharyngeal candidiasis at baseline and weekly thereafter during their radiation treatment. The scraping or swabs from the oral cavity were obtained and confirmed by use of a 10% KOH preparation.Overall oral candidiasis was recorded in 46.66% (56/120) of the patients, with Candida albicans 54. Increasing trend in radiation reactions, like severe odynophagia, dysphagia, grade 2 & 3 mucositis and oral secondary infection with increasing fungal or bacterial growth were significantly associated symbiotically from 3rdto 6th week of radiation therapy. During radical radiotherapy corticosteroid like dexamethasone 4mg i.v, b.id for 1 2 weeks is usually used for control of acute reactions like mucositis (Grade 2 and 3), odynophagia and dysphagia (severe). The use of corticosteroid during radiotherapy possibly suppresses the cellularimmunity and phagocytosis adding to its contribution towards increasing secondary infection. In our study 46.6% subjects developed oral candidiasis and corticosteroid for mucositis was used in 55.4% (61/110) of the patients for RTOG Grade 2 and 3 acute radiation reactions. Predisposing factors should be treated or eliminated were feasible. Antifungal agents play an important role in the management of fungal infectionsFungal infections during radiation therapy or Head & Neck cancers are common. Under suitable circumstances the normal commensal turns pathogenic. These infections contribute to increased acute radiation reacting, which in turn necessitates treatment interruptions.