Treatment of oral candidiasis in patients with head and neck cancer

Literature review

Abstract

Introduction: The treatment of head and neck cancer is related to several side effects, including oral candidiasis, which affects almost half of patients. Oral candidiasis is an opportunistic fungal infection that can compromise quality of life. It is associated with xerostomia, burning mouth, and even pneumonia due to the dissemination of the fungus. Treatment involves medications that aim to strengthen the immune system and antifungals. The various therapeutic modalities can confuse the clinician in the decision-making process on which measure to apply. Aim: To review the literature on the optimal treatment of oral candidiasis in patients with head and neck cancer. Methodology: A literature review was carried out with international articles published and available in the journals and databases of PubMed, Lilacs, and SciELO. The inclusion criteria were systematic reviews, clinical trials, cohort studies, case-control studies, and laboratory studies, published in the period between 2011 and 2022. The descriptors used were: oral candidiasis; head and neck cancer; oral cancer; pharyngeal cancer. Results: Eleven articles that clinically evaluated the effectiveness of antifungals were included. In general, the studies indicate that fluconazole serves as the first treatment option. Conclusion: This literature review shows a lack of clinical studies on the effectiveness of different antifungals for the treatment of oral candidiasis in patients with head and neck cancer. The results suggest that fluconazole can be used prophylactically and therapeutically.

Keywords: Oral Candidiasis; Head and neck cancer; Fluconazol; Radiotherapy.