PHARMACOLOGICAL MANAGEMENT OF ORAL LESIONS IN ADENOID CYSTIC CARCINOMA PATIENTS UNDERGOING RADIOTHERAPY

Authors

  • DESI ELVHIRA ROSA Oral Medicine Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Jalan Sekeloa Selatan I, 40132, Bandung, Indonesia
  • THEODORA ADHISTY Oral Medicine Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Jalan Sekeloa Selatan I, 40132, Bandung, Indonesia
  • TENNY SETIANI DEWI Department of Oral Medicine, Faculty of Dentistry, Universitas Padjadjaran, Jalan Sekeloa Selatan, I, 40132, Bandung, Indonesia

DOI:

https://doi.org/10.22159/ijap.2022.v14s4.OP07

Keywords:

Radiotherapy, Oral mucositis, Oral candidiasis, Nystatin oral suspension, Benzydamine, Saline

Abstract

Objective: This case report aimed to describe the pharmacological management of oral lesions in adenoid cystic submental carcinoma patients undergoing radiotherapy.

Methods: A 48 y old female undergoing radiotherapy complained of difficulty eating, swallowing, and speaking due to severe pain in her oral cavity for three weeks. Intra-oral examination revealed painful yellowish-white plaques that could not be scrapped on the tongue, maxillary and mandibular anterior gingiva, left and right buccal mucosa, and palate, diagnosed with oral candidiasis. We also found multiple shallow ulcers on the left buccal mucosa and upper labial mucosa that can be seen as oral mucositis.

Results: The patient was given nystatin oral suspension for oral candidiasis, benzydamine hydrochloride for the complaint of pain when swallowing, and saline for promoting wound healing and keeping the oral mucosa moist. These lesions healed in a week and she could eat solid food without pain.

Conclusion: Appropriate pharmacological management of oral lesions in a patient undergoing radiotherapy provides significant healing to better quality of life.

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References

Sari J, Nasiloski KS, Gomes APN. Oral complications in patients receiving head and neck radiation therapy: a literature review. RGO Rev Gauch. Odontol 2014;62(4):395-400. doi: 10.1590/1981-863720140004000007573.

Mons U, Gredner T, Behrens G, Stock C, Brenner H. Cancers due to smoking and high alcohol consumption. Dtsch arztebl Int. 2018;115(35-36):571-7. doi: 10.3238/arztebl.2018.0571, PMID 30236215.

Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE. Abeloff’s clinical oncology. 6th ed. Amsterdam: Elsevier; 2020.

Anderson G, Ebadi M, Vo K, Novak J, Govindarajan A, Amini A. An updated review on head and neck cancer treatment with radiation therapy. Cancers. 2021;13(19):1-12. doi: 10.3390/cancers13194912.

Ko C, Citrin D. Radiotherapy for the management of locally advanced squamous cell carcinoma of the head and neck. Oral Dis. 2009;15(2):121-32. doi: 10.1111/j.1601-0825.2008.01495.x, PMID 19036056.

Dillon PM, Chakraborty S, Moskaluk CA, Joshi PJ, Thomas CY. Adenoid cystic carcinoma: a review of recent advances, molecular targets, and clinical trials. Head Neck. 2016;38(4):620-7. doi: 10.1002/hed.23925, PMID 25487882.

Strojan P, Hutcheson KA, Eisbruch A, Beitler JJ, Langendijk JA, Lee AWM. Treatment of late sequelae after radiotherapy for head and neck cancer. Cancer Treat Rev. 2017;59:79-92. doi: 10.1016/j.ctrv.2017.07.003, PMID 28759822.

Ingrosso G, Saldi S, Marani S, Wong AYW, Bertelli M, Aristei C. Breakdown of symbiosis in radiation-induced oral mucositis. J Fungi (Basel). 2021;7(4):1-14. doi: 10.3390/jof7040290, PMID 33921294.

Sroussi HY, Epstein JB, Bensadoun RJ, Saunders DP, Lalla RV, Migliorati CA. Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med. 2017;6(12):2918-31. doi: 10.1002/cam4.1221, PMID 29071801.

Chae YK, Chung SY, Davis AA, Carneiro BA, Chandra S, Kaplan J. Adenoid cystic carcinoma: current therapy and potential therapeutic advances based on genomic profiling. Oncotarget. 2015;6(35):37117-34. doi: 10.18632/oncotarget.5076, PMID 26359351.

Rodriguez NM, Leco Berrocal I, Rubio Alonso L, Arias Irimia O, Martinez Gonzalez JM. Epidemiology and treatment of adenoid cystic carcinoma of the minor salivary glands: A meta-analytic studies. Med Oral Patol Oral Cir Bucal. 2011;16:7-12.

Glick M, Greenberg MS, Lockhart PB, Challacombe SJ. Burket’s oral medicine. 13th ed. Pondicherry: John Wiley & Sons; 2021.

Maria OM, Eliopoulos N, Muanza T. Radiation-induced oral mucositis. Front Oncol. 2017;7:89. doi: 10.3389/fonc.2017.00089, PMID 28589080.

Nishii M, Soutome S, Kawakita A, Yutori H, Iwata E, Akashi M. Factors associated with severe oral mucositis and candidiasis in patients undergoing radiotherapy for oral and oropharyngeal carcinomas: a retrospective multicenter study of 326 patients. Support Care Cancer. 2020;28(3):1069-75. doi: 10.1007/s00520-019-04885-z, PMID 31177394.

Homa Mlak I, Brzozowska A, Mlak R, Szudy Szczyrek A, Małecka Massalska T Homa. Neutrophil-to-lymphocyte ratio as a factor predicting radiotherapy-induced oral mucositis in head neck cancer patients treated with radiotherapy. J Clin Med. 2021;10(19):1-15. doi: 10.3390/jcm10194444, PMID 34640462.

Lalla RV, Sonis ST, Peterson DE. Management of oral mucositis in patients who have cancer. Dent Clin North Am. 2008;52(1):61-77. doi: 10.1016/j.cden.2007.10.002, PMID 18154865.

Belazi M, Velegraki A, Koussidou Eremondi T, Andreadis D, Hini S, Arsenis G. Oral candida isolates in patients undergoing radiotherapy for head and neck cancer: prevalence, azole susceptibility profiles and response to antifungal treatment. Oral Microbiol Immunol. 2004;19(6):347-51. doi: 10.1111/j.1399-302x.2004.00165.x, PMID 15491459.

Salvatori O, Puri S, Tati S, Edgerton M. Innate immunity and saliva in candida albicans-mediated oral diseases. J Dent Res. 2016;95(4):365-71. doi: 10.1177/0022034515625222, PMID 26747422.

Snider JW, Paine CC. Sticky stuff: xerostomia in patients undergoing head and neck radiotherapy-prevalence, prevention, and palliative care. Ann Palliat Med. 2020;9(3):1340-50. doi: 10.21037/apm.2020.02.36, PMID 32279510.

Dowd SJ, Johnson BS, Mariotti AJ. Pharmacology and therapeutics for dentistry. 7th ed. Amsterdam: Elsevier; 2017.

Quindos G, Gil-Alonso S, Marcos Arias C, Sevillano E, Mateo E, Jauregizar N. Therapeutic tools for oral candidiasis: current and new antifungal drugs. Med Oral. 2019. doi: 10.4317/medoral.22978.

Trevor AJ, Katzung BG, Kruiderring Hall M. Pharmacology examination and board review. 11th ed. New York: McGraw-Hill; 2015.

Lyu X, Zhao C, Yan ZM, Hua H. Efficacy of nystatin for the treatment of oral candidiasis: A systematic review and meta-analysis. Drug Des Devel Ther. 2016;10:1161-71. doi: 10.2147/DDDT.S100795, PMID 27042008.

Nicolatou Galitis O, Bossi P, Orlandi E, Rene Jean Bensadoun RJ. The role of Benzydamine in the prevention and treatment of chemoradiotherapy-induced mucositis. Support Care Cancer. 2021;29(10):5701-9. doi: 10.1007/s00520-021-06048-5, PMID 33649918.

Sheibani KM, Mafi AR, Moghaddam S, Taslimi F, Amiran A, Ameri A. Efficacy of Benzydamine oral rinse in prevention and management of radiation-induced oral mucositis: a double-blind placebo-controlled randomized clinical trial. Asia Pac J Clin Oncol. 2015;11(1):22-7. doi: 10.1111/ajco.12288, PMID 25471468.

Kazemian A, Kamian S, Aghili M, Hashemi FA, Haddad P. Benzydamine for prophylaxis of radiation-induced oral mucositis in head and neck cancers: A double-blind placebo-controlled randomized clinical trial. Eur J Cancer Care (Engl). 2009;18(2):174-8. doi: 10.1111/j.1365-2354.2008.00943.x, PMID 19267733.

Huang BS, Wu SC, Lin CY, Fan KH, Chang JTC, Chen SC. The effectiveness of a saline mouth rinse regimen and education programme on radiation-induced oral mucositis and quality of life in oral cavity cancer patients: a randomised controlled trial. Eur J Cancer Care (Engl). 2018;27(2):e12819. doi: 10.1111/ecc.12819, PMID 29315944.

Published

26-11-2022

How to Cite

ROSA, D. E., ADHISTY, T., & DEWI, T. S. (2022). PHARMACOLOGICAL MANAGEMENT OF ORAL LESIONS IN ADENOID CYSTIC CARCINOMA PATIENTS UNDERGOING RADIOTHERAPY. International Journal of Applied Pharmaceutics, 14(4), 163–166. https://doi.org/10.22159/ijap.2022.v14s4.OP07

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Section

Case Study(s)