Oropharyngeal Candidiasis in Head and Neck Cancer Patients Treated With Radiation: Update 2011

Support Care Cancer. 2011 Jun;19(6):737-44. doi: 10.1007/s00520-011-1154-4. Epub 2011 Apr 10.

Abstract

Background: Oropharyngeal candidiasis (OPC) is a major cause of morbidity in patients with malignancies. It is a common complication of head and neck radiation therapy and can result in pain, dysgeusia (taste changes), anorexia, malnutrition, and esophageal or systemic dissemination. Clinicians should be aware of current epidemiology, elements of diagnosis, and therapeutic trials guiding the recent recommendations for prophylaxis and management of OPC, a disease often incorrectly perceived as benign.

Methods: This review discusses OPC with focus in head and neck cancer patients receiving radiotherapy.

Results: Local treatments are recommended as first-line therapy in milder forms of OPC. In the setting of local therapy, products that provide prolonged contact time and are not sucrose sweetened may result in successful prevention and management with low risk of oral/dental complications.

Conclusion: Diagnosis and management of OPC is required in head and neck cancer patients treated with radiation. Local therapy is suggested as first-line treatment for OPC, unless severe clinical infection or high risk immune suppression necessitate systemic therapy. The availability of effective locally delivered (topical) medications may provide potential for prophylaxis for carriers of Candida species in head and cancer patients during radiation therapy.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use
  • Candida / isolation & purification
  • Candidiasis, Oral / drug therapy
  • Candidiasis, Oral / etiology*
  • Candidiasis, Oral / microbiology
  • Carrier State / epidemiology
  • Carrier State / microbiology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Pharyngeal Diseases / drug therapy
  • Pharyngeal Diseases / etiology*
  • Pharyngeal Diseases / microbiology
  • Risk Factors

Substances

  • Antifungal Agents