Punica granatum Linn. prevention of oral candidiasis in patients undergoing anticancer treatment

Manuela Gouvêa Campêlo Dos Santos,Danúbia Roberta De Medeiros Nóbrega,Jozinete Vieira Pereira,Daliana Queiroga De Castro Gomes,Rachel Reinaldo Arnaud,Ronaldo Campêlo Dos Santos

doi:10.1590/1807-2577.24015

Abstract

Abstract Introduction Oral candidiasis is considered one of the complications of antineoplastic therapy of head and neck. Studies show that herbal medicine has proven to be a promising alternative for the treatment of candidiasis. Objective To evaluate the effectiveness of the gel Punica granatum Linn. in the prevention of oral candidiasis in patients undergoing radiotherapy with or without chemotherapy for squamous cell carcinoma of the head and neck, and adverse effects associated with its use. Material and method It was performed a clinical trial, double blind, in the period 2012-2013, with patients seen at a referral hospital for cancer treatment. The sample consisted of 17 patients who did not have signs nor symptoms of oral candidiasis. These patients were divided into two groups: experimental (n=11): composed of patients who used the gel Punica granatum Linn. 6.25% since the beginning of the anticancer treatment and completed a week after the end of the treatment regimen; control (n=6): for patients who used the gel Miconazol 2%, following the same guidelines of the previous group. Data were tabulated and analyzed using descriptive statistics, the chi-square test and calculation of continuing Yates correction (p<0.05). Result There was no oral candidiasis in 63.6% of patients in the experimental group and in none of the control group patients. Conclusion Most patients who used the experimental gel showed no clinical signs of fungal infection, and there was no association of adverse effects.

Highlights

Oral candidiasis is considered one of the complications of antineoplastic therapy of head and neck
The increased risk of oral candidiasis is probably caused by the fall of salivary flow as a consequence of radiotherapy
The sample consisted of patients from both genders, older than years old, for the first time submitted to external radiotherapy for the treatment of malign neoplasies in head and neck regions, with exclusive indication or concurrent with chemotherapy or surgery and whose radiation field, covered at least half the mucosa coating area of the oral cavity

Summary

Introduction

Oral candidiasis is considered one of the complications of antineoplastic therapy of head and neck. The standard therapy for most of the malign neoplasies in head and neck regions usually consists of surgery or radiotherapy for the treatment of the disease, associated or not to chemotherapy, or they can be concurent[1]. Both the radiotherapy and the chemotherapy are related to a variety of oral complications, because they do not differentiate neoplastic cells from regular cells, among them, xerostomia, oral mucositis and candidiasis, which can compromise the life quality of the patients during the treatment[2,3]. A possible explanation for irradiated patients’ greater disposition to candidiasis, is a reduced phagocytic activity of the salivary granulocytes against these microorganisms[8]

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