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光动力疗法控制头颈放疗患儿口腔念珠菌病。

Photodynamic therapy to control oral candidiasis in a pediatric patient undergoing head and neck radiotherapy.

机构信息

Pediatric Oncology Institute/GRAACC (Support Group for Children and Adolescents with Cancer), São Paulo, Brazil.

Pediatric Oncology Institute/GRAACC (Support Group for Children and Adolescents with Cancer), São Paulo, Brazil.

出版信息

Photodiagnosis Photodyn Ther. 2022 Mar;37:102627. doi: 10.1016/j.pdpdt.2021.102627. Epub 2021 Nov 17.

Abstract

Candida albicans is an opportunistic yeast of the oral microbiome which can cause candidiasis in systemically susceptible individuals, such as those undergoing cancer treatment. The local management of the oral lesions is challenging and may be significantly improved with photodynamic therapy (PDT). PDT consists of an association of light with a photosensitizing agent and oxygen, whose interaction produces reactive oxygen species capable of reducing non-specific microbial contamination without causing side effects. This study aimed to report a case in which oral candidiasis was managed with PDT. A 12-year-old male patient undergoing head and neck radiotherapy (HNRT) for Undifferentiated Mesenchymal Neoplasm presented with dysgeusia, oral pain, and yeast infection on the 13th session of HNRT. The patient used topical antifungals for 30 consecutive days with no lesion or symptom remission. PDT was then proposed and the lesion was healed after a single PDT session, with no further clinical signs of infection and return to normal oral function. Local and non-invasive management of oral candidiasis is of utmost importance for immunocompromised patients, with good acceptability, no systemic side effects, and no drug interactions.

摘要

白色念珠菌是口腔微生物组中的一种机会性酵母,可使癌症治疗等全身易感个体发生念珠菌病。口腔病变的局部治疗具有挑战性,光动力疗法(PDT)可能显著改善这种情况。PDT 由光与光敏剂和氧气联合组成,其相互作用产生的活性氧能够减少非特异性微生物污染而不会产生副作用。本研究旨在报告一例口腔念珠菌病经 PDT 治疗的病例。一名 12 岁男性患者,因未分化间充质肿瘤接受头颈部放疗(HNRT),在 HNRT 的第 13 次治疗时出现味觉障碍、口腔疼痛和酵母感染。患者连续使用局部抗真菌药 30 天,但无病变或症状缓解。随后提出 PDT 治疗,单次 PDT 治疗后病变愈合,无进一步感染的临床迹象,口腔功能恢复正常。对于免疫功能低下的患者,局部和非侵入性的口腔念珠菌病管理非常重要,具有良好的可接受性、无全身副作用和无药物相互作用。

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