Comparison of oral candidiasis characteristics in head-and-neck cancer patients before and during radiotherapy

Zahra Golestannejad; Faezeh Khozeimeh; Nadia Najafizade; Adel Tabesh; Elham Faghihian; Mehrnoush Maheronnaghsh; Mahnaz Kheirkhah; Sayed Mohsen Hosseini; Leila Sadeghalbanaei; Mina Jamshidi; Ahmad Amiri Chermahini; Zahra Saberi; Fahimeh Pakravan; Parvin Dehghan; Maryam Emamibafrani; Nima Amini; Faezeh Tadayon

Comparison of oral candidiasis characteristics in head-and-neck cancer patients before and during radiotherapy

Dent Res J (Isfahan). 2023 May 26:20:63. eCollection 2023.

Authors

Zahra Golestannejad¹, Faezeh Khozeimeh¹, Nadia Najafizade², Adel Tabesh¹, Elham Faghihian¹, Mehrnoush Maheronnaghsh³, Mahnaz Kheirkhah³, Sayed Mohsen Hosseini⁴, Leila Sadeghalbanaei⁵, Mina Jamshidi⁶, Ahmad Amiri Chermahini⁷, Zahra Saberi¹, Fahimeh Pakravan⁸, Parvin Dehghan⁹, Maryam Emamibafrani¹⁰, Nima Amini¹¹, Faezeh Tadayon¹⁰

Affiliations

¹ Department of Oral and Maxillofacial Medicine, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
² Department of Radiation Oncology, Isfahan University of Medical Sciences, Isfahan, Iran.
³ Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
⁴ Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
⁵ Department of Orthodontics, Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
⁶ Department of Periodontics, Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
⁷ Department of Endodontics, Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran.
⁸ Department of Oral and Maxillofacial Medicine, Dental Implants Research Center, School of Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
⁹ Department of Mycology and Parasitology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
¹⁰ Department of Dentist, Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
¹¹ Department of Pediatric Dentistry, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.

PMID: 37388299
PMCID: PMC10300268

Abstract

Background: Patients undergoing head-and-neck radiotherapy are susceptible to Candida colonization and infection. This study aimed to identify oral Candida species type (ST), colony count (CC), and oropharyngeal candidiasis (OPC) in head-and-neck cancer patients, undergoing radiotherapy, before and 2 weeks after radiation.

Materials and methods: In this quasi-experimental study, head-and-neck cancer patients undergoing radiotherapy (up to 6000 cGy) were recruited. Samples were taken before and 2 weeks after radiation therapy (RT). CC was assigned using Sabouraud dextrose agar culture medium and morphological studies were performed to confirm OPC. For identification, polymerase chain reaction-restriction fragment length polymorphism was performed. Data were analyzed using Chi-square-test and kappa coefficient. P < 0.05 was considered statistically significant.

Results: Twenty-one of 33 patients were Candida positive. The detected fungal species included Candida albicans (60%), Candida tropicalis (22%), Candida glabrata (9%), and other species (9%). Following RT, OPC and CC changed significantly (P = 0.003 and P = 0.001, respectively), whereas ST did not significantly change (P = 0.081). Two new species (Candida krusei and Candida parapsilosis) were detected after the intervention. The OPC, CC, and ST changes after RT were not significantly related to malignancy site or radiation dose (P > 0.05).

Conclusion: The present study showed that OPC, CC, and ST were not related to the malignancy site. Following RT, OPC and CC changed significantly, while ST showed no significant change. The radiation dose and malignancy site had no effects on the OPC, CC, or ST alterations following RT.

Keywords: Candida; head-and-neck neoplasms; radiotherapy.