Tsuyuki Shigeru, Kawaguchi Kosuke, Kawata Yukiko, Yamaguchi Ayane, Kanazawa Akiyoshi, Sugitatsu Mitsuchika, Kono Yukihiro
Dept. of Breast and General Surgery, Osaka Red Cross Hospital.
Gan To Kagaku Ryoho. 2012 Sep;39(9):1369-73.
Chemotherapy-induced oral mucositis is a common adverse event in breast cancer patients. Breakdown of the mucosal barrier predisposes the patient to bacterial, fungal and viral superinfection, especially candidiasis. We demonstrated the frequency of chemotherapy-induced oral mucositis and oral candidiasis, and the efficacy of antimycotic agents in breast cancer patients. We investigated 32 patients with advanced and metastatic breast cancer who underwent chemotherapy in our department from March, 2009 to August, 2010. The chemotherapy regimens were as follows: FEC (epirubicin/5-FU/cyclophosphamide) followed by taxanes: 21, FEC: 1, TC (docetaxel/cyclophosphamide): 7, DOC (docetaxel): 3, and CPT-11/S-1: 1. Patients had blood and bacteria tests of the oral cavity at the time mucositis symptoms appeared. We administered an antimycotic agent (itraconazole) and evaluated its effect on mucositis at the time mucositis symptoms appeared. 56. 3% of patients had chemotherapy-induced oral mucositis, and 38. 9% of the mucositis patients had oral candidiasis. The incidence of mucositis increased when severe neutropenia occurred. 92. 9% of mucositis patients were cured or improved by itraconazole. In conclusion, chemotherapy caused oral candidiasis in 40% of cases with oral mucositis, and in about 56% of breast cancer patients. The antimycotic agent may be useful for chemotherapy-induced oral mucositis in breast cancer patients.
化疗引起的口腔黏膜炎是乳腺癌患者常见的不良事件。黏膜屏障的破坏使患者易发生细菌、真菌和病毒的二重感染，尤其是念珠菌病。我们证实了化疗引起的口腔黏膜炎和口腔念珠菌病的发生率，以及抗真菌药物对乳腺癌患者的疗效。我们调查了2009年3月至2010年8月在我科接受化疗的32例晚期和转移性乳腺癌患者。化疗方案如下：FEC（表柔比星/5-氟尿嘧啶/环磷酰胺）序贯紫杉烷类：21例，FEC：1例，TC（多西他赛/环磷酰胺）：7例，DOC（多西他赛）：3例，CPT-11/S-1：1例。患者在出现黏膜炎症状时进行了血液和口腔细菌检测。在出现黏膜炎症状时，我们给予抗真菌药物（伊曲康唑）并评估其对黏膜炎的疗效。56.3%的患者发生了化疗引起的口腔黏膜炎，其中38.9%的黏膜炎患者合并口腔念珠菌病。严重中性粒细胞减少时黏膜炎的发生率增加。92.9%的黏膜炎患者经伊曲康唑治疗后治愈或好转。总之，化疗在40%的口腔黏膜炎病例中导致口腔念珠菌病，在约56%的乳腺癌患者中导致该病。抗真菌药物可能对化疗引起的乳腺癌患者口腔黏膜炎有用。
