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AIM: To fabricate and evaluate the efficacy of individualized intraoral stents to minimize the potential side effects of radiation on oral tissues in patients with early stages of lip cancer. BACKGROUND: Lower lip cancer is a common tumor found almost exclusively in middle-aged and elderly males. Surgery is the most common treatment of choice, although for less extensive lesions, exclusive radiotherapy may be preferred. Some studies have found that the use of intraoral stents in patients with intraoral cancer (e.g., of the tongue or floor of the mouth) obtained favorable results in preventing unnecessary radiation doses to adjacent normal tissue and reducing oral complications. However, studies investigating the efficacy of individualized intraoral stents in patients with lip cancer have not been reported in the literature. MATERIALS AND METHODS: Six patients with early stage lip cancer were eligible for curative radiotherapy and personalized intraoral stents. The stents were fabricated and all participants were evaluated for the occurrence of oral complications. RESULTS: The regions of the oral mucosa protected from radiation by intraoral stents showed no mucositis. One patient complained of mild oral dryness but without interference in habits. At follow-up, none of the patients had late xerostomia or signs of dental caries by radiation. CONCLUSIONS: The use of individualized intraoral stents was shown to be promising in reducing the adverse effects of radiation therapy in lip cancer patients. These findings highlight the importance of a multidisciplinary team during oncological therapy.
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OBJECTIVE: This paper aimed to identify and quantify Candida on head and neck irradiated patients with two comparative elderly populations. MATERIALS AND METHODS: Saliva was sampled from 29 head and neck irradiated patients (group 1) 34 non-institutionalized elderly patients (group 2) and 29 institutionalized elders (group 3) and matched by age. For quantification, the obtained saliva was sewed on CHROMagar Candida(®), which was used also for presumptive identification of Candida, API 20C AUX(®), microculture and RAPD (OPE-18) were used for the final identification. RESULTS: Among the 92 patients surveyed, 51 (55.4%) had scores classified as positive for Candida, and among individuals of groups 1 and 3, 58.6% had Candida. There was higher positive/carrier conditions (CFU/sample) in groups 1 and 3, comparing with group 2 (P=0.011). Gender was not associated with Candida portability (P=0.334). Candida portability was significantly associated with the presence of candidosis (P=0.031) and xerostomic state (P=0.007). The isolates and definitive confirmed colonies were Candida albicans, Candida dubliniensis, Candida tropicalis, Candida krusei, Candida glabrata, Candida parapsilosis, Candida guilliermondii, Candida lusitaniae, and Candida kefyr. Among the species identified, C. albicans was the most frequent, followed by C. tropicalis, C. parapsilosis and C. glabrata. C. albicans was more prevalent in group 2 and 3, 45% and 41.2%, respectively, whereas, the most prevalent species in group 1 were C. tropicalis (27%), C. albicans and C. parapsilosis (16.2% for both). On multiple statistical models, only radiotherapic treatment was associated with positiveness to Candida. CONCLUSIONS: Diversification and major prevalence of non-albicans species were observed in irradiated patients on head and neck and this treatment is straightly associated with fungus positiveness.
