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

Mario Busetto, Vincenzo Fusco, Franco Corbella, Mario Bolzan, Giovanni Pavanato, Bartolomea Bonetti, Francesca Maggio, Marco Orsatti, Costantino De Renzis, Giovanni Mandoliti, Guido Sotti, Michela Buglione Di Monale E Bastia, Giacomo Turcato, Sara Colombo, Stefano Maria Magrini, Rosa Bianca Guglielmi, Luca Cionini, Paolo Montemaggi, Gino Panizzoni, Paolo DeliaFrancesco Sciumé, Giovanni Castaldo, Francesco Matteucci, Lucio Loreggian, Guido Sansotta, Luciana Lastrucci

Research output: Contribution to journalArticlepeer-review

Abstract

Background and purpose 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. Materials and 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 >70 years 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 (>12 days) 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.

Original languageEnglish
Pages (from-to)303-310
Number of pages8
JournalRadiotherapy and Oncology
Volume109
Issue number2
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Head & Neck
  • Mycosis
  • Oropharynx
  • Predictive factors

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

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