Factors associated with severe oral mucositis and candidiasis in patients undergoing radiotherapy for oral and oropharyngeal carcinomas: a retrospective multicenter study of 326 patients

Nishii, Mika; Soutome, Sakiko; Kawakita, Akiko; Yutori, Hirokazu; Iwata, Eiji; Akashi, Mitsuru; Hasegawa, Takumi; Kojima, Yasuyuki; Funahara, Madoka; Umeda, Masahiro; Komori, Takahide

doi:10.1007/s00520-019-04885-z

Cited by 66 publications

(43 citation statements)

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“…Pawar et al (2014) showed that Salmonella enterica serovar Typhimurium can invade solid tumours and produce biofilms similarly to P aeruginosa . There is less evidence for an association between fungi and cancer; it was shown that lesions on the oral mucosa have a greater likelihood of undergoing malignant transformation when infected with Candida compared with those that are not infected . Furthermore, the adherence and biofilm production of Candida cells on patient mucosa is higher following radiotherapy, both in terms of number of cells and total biomass production, which may be associated with the increased frequency of fungal mucosal infections …”

Section: Discussionmentioning

confidence: 99%

“…30 There is less evidence for an association between fungi and cancer; it was shown that lesions on the oral mucosa have a greater likelihood of undergoing malignant transformation when infected with Candida compared with those that are not infected. [31][32][33] Furthermore, the adherence and biofilm production of Candida cells on patient mucosa is higher following radiotherapy, both in terms of number of cells and total biomass production, which may be associated with the increased frequency of fungal mucosal infections. 34,35 We observed candidaemia with bacteraemia in 34% of all cases consistent with the previously described data ranging from 6% to 34.5%.…”

Section: Et Al (2012) Proved That Intravenously Administered Planktonicmentioning

confidence: 99%

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Candida biofilm production is associated with higher mortality in patients with candidaemia

Vitális

Nagy

Tóth

et al. 2020

Mycoses

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Summary Background Candidaemia is a common life‐threatening disease among hospitalised patients, but the effect of the Candida biofilm‐forming ability on the clinical outcome remains controversial. Objective The aim was to determine the impact of biofilms, specifically focusing on biofilm mass and metabolic activity, on the mortality in candidaemia. Patients/Methods The clinical data of patients (n = 127) treated at the University of Debrecen, Clinical Centre, between January 2013 and December 2018, were investigated retrospectively. Biofilm formation was assessed using the crystal violet and XTT assays, measuring the biofilm mass and metabolic activity, respectively. Isolates were classified as low, intermediate and high biofilm producers both regarding biofilm mass and metabolic activity. The susceptibility of one‐day‐old biofilms to fluconazole, amphotericin B, anidulafungin, caspofungin and micafungin was evaluated and compared to planktonic susceptibility. Results Intermediate/high biofilm mass was associated with significantly higher mortality (61%). All Candida tropicalis, Candida parapsilosis and Candida glabrata isolates originating from fatal infections were intermediate/high biofilm producers, whereas this ratio was 85% for Candida albicans. Solid malignancy was associated with intermediate/high biofilm producers (P = .043). The mortality was significantly higher in infections caused by Candida strains producing biofilms with intermediate/high metabolic activity (62% vs. 33%, P = .010). The ratio of concomitant bacteraemia was higher for isolates forming biofilms with low metabolic activity (53% vs 28%, P = .015). Conclusions This study provides evidence that the Candida biofilms especially with intermediate/high metabolic activity are related to higher mortality in candidaemia.

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Section: Discussionmentioning

confidence: 99%

Section: Et Al (2012) Proved That Intravenously Administered Planktonicmentioning

confidence: 99%

Candida biofilm production is associated with higher mortality in patients with candidaemia

Vitális

Nagy

Tóth

et al. 2020

Mycoses

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“…In an observational study of 326 patients with oral or oropharyngeal cancer, it was found that the risk factors for oral candidiasis were leukopenia and exacerbation of stomatitis, and that steroid ointment was not a risk factor. 9 For these reasons, we conducted a preliminary study to determine the efficacy of Episil® using dexamethasone ointment as the control treatment.…”

Section: Discussionmentioning

confidence: 99%

Effects of a bioadhesive barrier-forming oral liquid on pain due to radiation-induced oral mucositis in patients with head and neck cancer: A randomized crossover, preliminary study

Soutome

Yanamoto

Kawashita

et al. 2021

Journal of Dental Sciences

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Background/purpose Bioadhesive barrier-forming oral liquid, is a recently developed medical material for the management of pain caused by oral mucositis associated with cancer radiotherapy or chemotherapy. The purpose of this study was to evaluate the effectiveness of this liquid in relieving pain resulting from radiation-induced oral mucositis in patients with head and neck cancer. Materials and methods This randomized, crossover trial investigated the analgesic effects of bioadhesive barrier-forming oral liquid using dexamethasone ointment as a control. Fifteen patients with mild or moderate pain due to radiation-induced oral mucositis were randomly assigned to two groups. Group A applied dexamethasone ointment once on day 1, had a wash-out period on day 2, and used bioadhesive barrier-forming oral liquid once on day 3. Conversely, group B used bioadhesive barrier-forming oral liquid on day 1, had a wash-out period on day 2, and applied dexamethasone ointment once on day 3. The effectiveness in relieving pain was compared between the two groups. Results One patient reported nausea immediately after the application of bioadhesive barrier-forming oral liquid and was therefore excluded from the analysis. Dexamethasone ointment and bioadhesive barrier-forming oral liquid relieved pain in 85.7% and 71.4% patients, respectively (p = 0.682). Nine patients wished to continue dexamethasone ointment after the study, while only five wished to continue bioadhesive barrier-forming oral liquid. Conclusion Our findings suggest that the analgesic effect of bioadhesive barrier-forming oral liquid is comparable or inferior to that of dexamethasone ointment in patients with radiation-induced oral mucositis. Further studies are needed to verify these findings.

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“…However, it has also been established that inadvertent use of steroids can result in infection, and there is a concern that the use of steroid ointment in cancer patients with reduced overall health could increase the risk of oral candidiasis. In an observational study of 326 patients with oral or oropharyngeal cancer, we recently reported that the risk factors for oral candidiasis were leukopenia and exacerbation of stomatitis, and that steroid ointment was not a risk factor [9]. For these reasons, we conducted a preliminary study to determine the e cacy of Episil® using dexamethasone ointment as a control treatment.…”

Section: Discussionmentioning

confidence: 99%

Effects of bio-adhesive barrier-forming oral liquid (Episil®) on pain due to radiation-induced oral mucositis in patients with head and neck cancer: A randomized crossover trial

Soutome¹,

Yanamoto

Kawashita³

et al. 2020

Preprint

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Background Bio-adhesive barrier-forming oral liquid (Episil®) is a recently developed medical device for the management of pain caused by oral mucositis associated with cancer radiotherapy or chemotherapy. The purpose of this study was to evaluate the effectiveness of this material for the relief of pain resulting from radiation-induced oral mucositis in patients with head and neck cancer who are undergoing radiotherapy.Methods This was a randomized, open-labeled, crossover trial investigating the pain relief effects of Episil® using dexamethasone ointment as a control. Fifteen patients who had mild or moderate pain due to radiation induced oral mucositis were randomly assigned to two groups: group A applied dexamethasone ointment once on the first day, had a wash-out period on the second day, and used Episil® once on the third day. Conversely, group B used Episil® on day 1, followed by a wash-out period on day 2 and dexamethasone ointment on day 3. The effectiveness of the test drug/materials on the relief of pain was compared.Results One patient reported nausea immediately after application of Episil® and was therefore excluded from the analysis of pain relief. Dexamethasone ointment relieved pain in 85.7% of patients compared to 71.4% with Episil® (p = 0.682). Nine patients wished to continue dexamethasone ointment after the study while only five wished to continue Episil®.Conclusions Our findings suggest that the pain relief effect of Episil® is comparable to or less than that of dexamethasone ointment. Larger follow-up studies are needed to verify these findings.Trial registration:The study protocol was registered in the Japan Registry of Clinical Trials (jRCT) on March 3rd, 2019 (jRCTs072180039).

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Factors associated with severe oral mucositis and candidiasis in patients undergoing radiotherapy for oral and oropharyngeal carcinomas: a retrospective multicenter study of 326 patients

Cited by 66 publications

References 10 publications

Candida biofilm production is associated with higher mortality in patients with candidaemia

Candida biofilm production is associated with higher mortality in patients with candidaemia

Effects of a bioadhesive barrier-forming oral liquid on pain due to radiation-induced oral mucositis in patients with head and neck cancer: A randomized crossover, preliminary study

Effects of bio-adhesive barrier-forming oral liquid (Episil®) on pain due to radiation-induced oral mucositis in patients with head and neck cancer: A randomized crossover trial

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