Oropharyngeal candidosis relative frequency in radiotherapy patient for head and neck cancer

Radiation given during treatment of oral and pharyngeal malignancy frequently causes alteration of the oral environment predisposing to the colonization of the oral mucosa by yeast species most frequently Candida.

Thus, this study was undertaken in 107 patients to find out association between radiation therapy and frequency of oropharyngeal candidosis, to quantitate colony forming units (CFUs) to identify Candida at species level and to check the incidence of serotype A and B in C. albicans.

The study was done on patients suffering from oropharyngeal cancer who were advised radiotherapy. The oral rinse collection method was used to collect the sample. Sabourauds Dextrose Agar (SDA) was used as primary culture media and subsequently speciation was done using standard techniques. The strains of C. albicans were serotyped employing the method described by Hansclever and Mitchell (1961, J Bacteriol 1961;82:570-3).

26.16% patients were mycologically positive for candida before radiotherapy with CFUs 100. 14 ± 59.11 that increased to 60.74% patients during radiotherapy with an increase in CFUs to 490.15 ± 207.97. Clinically, grading of mucositis was done and also individual signs and symptoms were noted in each patient. The occurrence of erythmatous lesions, ulceration, and xerostomia were found to be statistically significant (P<0.05). C. albicans was the most frequently encountered species with higher prevalence of serotype A suggesting higher virulent species.

It is proposed that in such patients taking radiotherapy prophylactic antifungal treatment should be given specially in patients showing development of oral mucosal lesions such as erythmatous lesions, ulcerations, and complaining about dryness of mouth, that is, xerostomia irrespective of presence or absence of clinical oral candidosis.