The Management of Oral Mucositis, Angular Cheilitis and Acute Pseudomembranous Candidiasis Induced by Radiotherapy and Chemotherapy Treatment of Nasopharyngeal Cancer Patient

Abstract

Radio-chemotherapy of the head and neck area can cause mucositis in cases of nasopharyngeal cancer that

is felt as swallowing pain, dry mouth and loss of taste. This condition is often exacerbated by the onset of

candidiasis on the oral mucosa. The aim of the case report was to inform the side effects of chemotherapy

and radiotherapy treatments in nasopharyngeal cancer patients that occur in the oral cavity include angular

cheilitis, acute pseudomembranous candidiasis and oral mucositis type 1 and their management. Case report,

a 69 year old-man, came to the dental clinic of the Sardjito hospital with complaints of pain to swallow food,

and his mouth had many white spots. Complaints were felt one week after the 3rd chemotherapy and 9th

radiotherapy. The patient was diagnosed with nasopharyngeal cancer (NPC) with T2N3M0 classification.

Clinical examination showed the presence of a white layer on the mucosa of the tongue, cheeks, palate

and lip mucosa. The entire oral mucosa was dark red, and angular cheilitis on both corners of the lips

was found. Treatment of this case by eliminating the necrotic tissue and debris by 3% hydrogen peroxide

solution mouth rinse and administration of drugs, including candystin droops and betadine mouth rinse for

1 week. The patient can swallow and eat a little hard without any more pain after 1 week treatment. Clinical

examination found that the white spots on the tongue, palate, cheeks and lips were gone. The color of the oral

mucosa appeared the same as the surrounding tissue. The oral hygiene and general conditions were good. In

conclusion, oral mucositis and acute pseudomembranous candidiasis due to chemo-radiotherapy treatment

in nasopharyngeal cancer patient were disappearing, and the oral condition has improved. Patients can chew

and swallow food without any pain.