Evaluation of oral mucositis, candidiasis, and quality of life in patients with head and neck cancer treated with a hypofractionated or conventional radiotherapy protocol: a longitudinal, prospective, observational study

Ferreira, Pedro Maciel de Vasconcellos; Gomes, Marina de Castro Monteiro Franco; Almeida, Ana Clara Speziali Menegazzi; Cornélio, Júlia Soares; Arruda, Thiago Jardim; Mafra, Arnoldo; Nunes, Marcelo Henrique Silva; Salera, Rafael Borges; Nogueira, Raquel; Sclauser, Juliana Maria Braga; Drummond-Lage, Ana Paula; Rezende, Bruno Almeida

doi:10.1186/s13005-023-00356-3

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…Oral candidiasis increased from 9.1% in an intermediate evaluation to 15.2% in a final evaluation among 66 patients undergoing head and neck radiotherapy at the Mario Penna Institute (Belo Horizonte, Minas Gerais, Brazil) [29]. At baseline, 44.7% of oral swabs tested positive for Candida colonization in a study conducted by Rupe and colleagues [30] at Gemelli Advanced Radiation Therapy (ART), Fondazione Policlinico Universitario A. Gemelli-IRCSS.…”

Section: Oropharyngeal Candidiasismentioning

confidence: 99%

Natural Compounds with Antimicrobial Activities in Oral Candida Infections during Head and Neck Radiotherapy

Imperia,

Bonincontro,

Altomare

et al. 2023

Chemotherapy

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Backgrounds: Oral colonization and infections are frequently observed in patients during and soon after radiation therapy (RT). Infective mucositis is a common side effect associated with cancer therapy, characterized by an inflammation of the oral mucous membranes with histological mucosal and submucosal changes. Ulcerative mucositis is responsible for significant pain, impairing the patient's nutritional intake and leading to local or systemic infections promoting mycosis due to several species of the genus Candida. According to international guidelines, treatment of candidiasis depends on the infection site and patient’s condition. Summary: Recently several studies have shown the protective role of natural compounds counteracting the activity of Candida biofilms. The aim of this review is to discuss the antimicrobial activities of natural compounds in fungal infections, especially Candida spp., during and soon after radiotherapy. Indeed new molecules are being discovered and assessed for their capacity to control Candida spp. growth and, probably in the future, will be used to treat oral candidiasis, overall, during radiotherapy. This review reports several preliminary data about preclinical and clinical evidence of their efficacy in the prevention and/or treatment of mucositis due to Radiotherapy with a brief description of the natural compounds with anti-Candida activities. Key messages: The increase in the resistance to the available antifungal drugs related to Candida spp. infections increased as well as drug interactions, urging the development of innovative and more effective agents with antifungal action. Recent preclinical and clinical studies are identifying natural substances with anti-inflammatory and antifungal activity that could be tested in the prevention of candidiasis in patients undergoing radiotherapy. Further studies are needed to confirm these preliminary data.

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Section: Oropharyngeal Candidiasismentioning

confidence: 99%

Natural Compounds with Antimicrobial Activities in Oral Candida Infections during Head and Neck Radiotherapy

Imperia,

Bonincontro,

Altomare

et al. 2023

Chemotherapy

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Moxidectin elevates Candida albicans ergosterol levels to synergize with polyenes against oral candidiasis

Ye,

Liu,

Chen

et al. 2024

Appl Microbiol Biotechnol

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Candida albicans, the most common opportunistic pathogenic fungus, is also the main pathogenic organism for oral candidiasis. This condition is particularly prevalent among the elderly, children, and individuals undergoing radiotherapy or suffering from HIV. The lack of new antifungal drugs, and drug resistance coupled with the side effects of current antifungal agents have increased the challenges of clinical antifungal therapies. Polyenes, including amphotericin B and nystatin, are clinical fungicidal drugs, however, their side effects and low solubility have limited their clinical applications. Here, we identified that moxidectin, a novel approved antiparasitic agent, could synergize with both amphotericin B and nystatin to inhibit the growth and biofilm formation of Candida albicans including 60 clinical isolates. The transcriptome and RT-PCR analysis indicated that moxidectin activated the biosynthesis pathway of ergosterol, the direct target of polyenes, further being verified by the loss of the synergistic activities with polyenes against ergosterol pathway mutants, including Δ/Δerg3 , Δ/Δerg11 and Δ/Δerg3 Δ/Δerg11 . Moxidectin was then confirmed to elevate the ergosterol biosynthesis levels of C. albicans and enhance the binding between cells and polyenes. In a mouse oral candidiasis model, moxidectin combined with low dosages of polyenes to significantly reduce the infection area, colonization of C. albicans and the inflammatory degree of tongue mucosa. Our study originally demonstrated that moxidectin could activate the ergosterol biosynthesis then elevate the ergosterol contents to enhance the antifungal effects of polyenes against C. albicans and its infections. Moxidectin can serve as the candidate potentiator of polyenes for further clinical practice. Key points • Moxidectin synergized with polyenes against Candida albicans. • Moxidectin activated the ergosterol biosynthesis of Candida albicans. • Moxidectin combined with polyenes to effectively combat oral candidiasis in mice. Supplementary information The online version contains supplementary material available at 10.1007/s00253-024-13343-8.

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Comment on prospective comparison of acute severe toxicities between smokers and non-smokers during radiotherapy for head and neck cancers

Topkan,

Somay,

Bascil

et al. 2024

Oral Oncology

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Evaluation of oral mucositis, candidiasis, and quality of life in patients with head and neck cancer treated with a hypofractionated or conventional radiotherapy protocol: a longitudinal, prospective, observational study

Cited by 3 publications

References 34 publications

Natural Compounds with Antimicrobial Activities in Oral Candida Infections during Head and Neck Radiotherapy

Natural Compounds with Antimicrobial Activities in Oral Candida Infections during Head and Neck Radiotherapy

Moxidectin elevates Candida albicans ergosterol levels to synergize with polyenes against oral candidiasis

Comment on prospective comparison of acute severe toxicities between smokers and non-smokers during radiotherapy for head and neck cancers

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