Fluconazole prophylaxis in patients with head and neck tumours undergoing radiation and radiochemotherapy

The aim of the present study was to investigate the incidence of Candida st omatitis and resulting interruptions in radiation and radiochemotherapy in 50 patients suffering from squamous cell carcinomas of the head and neck re gion receiving fluconazole (100 mg d(-1)) in comparison with a historical c ontrol group (n=50) without specific prophylaxis. Twenty of the control pat ients (40%) demonstrated Candida stomatitis, with seven of them (14%) requi ring interruptions in anticancer therapy. In contrast, none of the patients with fluconazole had evidence of Candida stomatitis (P=0.0000051) and subs equent interruption of anti-cancer therapy (P=0.0061). Laboratory monitorin g for the presence of Candida species was performed in 30 patients before a nd after therapy with fluconazole. Candida albicans was identified less fre quently after therapy when compared with the pretreatment status. However, C. glabrata and C, krusei were isolated in some of the patients, probably b ecause of drug resistance of these subspecies. The results demonstrate the clinical usefulness of prophylactic fluconazole applications in patients su ffering from head and neck tumours with the aim of reducing Candida stomati tis and the resulting interruptions in radiation and radiochemotherapy.