Redding Spencer W, Dahiya Marta C, Kirkpatrick William R, Coco Brent J, Patterson Thomas F, Fothergill Annette W, Rinaldi Michael G, Thomas Charles R
Department of General Dentistry, University of Texas Health Science Center at San Antonio, South Texas Veterans Healthcare System, TX 78229-3900, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Jan;97(1):47-52. doi: 10.1016/j.tripleo.2003.09.008.
Oropharyngeal candidiasis (OPC) is relatively common in patients receiving radiation for head and neck cancer occurring in approximately 25% of patients. Candida albicans has been described as the primary infecting organism. Recently, other organisms, particularly Candida glabrata, have emerged as causative agents of OPC among immunocompromised patients. This study describes the characteristics of 6 patients with head and neck cancer treated with radiotherapy at our institution, who were found to have Candida glabrata-associated OPC and their responses to oral fluconazole. All 6 patients were successfully treated with oral fluconazole. However, most did not respond to the usual dose of 100 mg/day necessitating doses ranging from 200 to 800 mg/day to achieve clinical cure. All 3 patients receiving radiation only were successfully treated with up to 200 mg/day; 2 of 3 patients receiving concomitant chemoradiation required doses ranging from 400 to 800 mg/day. As with systemic infection, previous fluconazole use appears to be a risk factor for this infection, but not with all patients.
口咽念珠菌病（OPC）在接受头颈部癌症放疗的患者中较为常见，发生率约为25%。白色念珠菌被认为是主要的感染病原体。最近，其他病原体，尤其是光滑念珠菌，已成为免疫功能低下患者OPC的致病因素。本研究描述了在我们机构接受放疗的6名头颈部癌症患者的特征，这些患者被发现患有光滑念珠菌相关的OPC以及他们对口服氟康唑的反应。所有6例患者均成功接受口服氟康唑治疗。然而，大多数患者对通常剂量的每日100毫克无反应，需要200至800毫克/天的剂量才能实现临床治愈。仅接受放疗的所有3例患者使用高达200毫克/天的剂量均成功治愈；接受同步放化疗的3例患者中有2例需要400至800毫克/天的剂量。与全身感染一样，既往使用氟康唑似乎是这种感染的一个危险因素，但并非所有患者都是如此。
