Candidíase em pacientes com câncer de cabeça e pescoço

Abstract

INTRODUCTION: The treatment of neoplasms in the head and neck usually involves surgery, associated with radio- and chemotherapy. Though anti-neoplastic therapy promotes the destruction of malignant cells, side effects are present in cancer treatment. Among them, oral candidiasis is one of the main harmful effects, affecting almost half of the patients. Oral candidiasis is an opportunistic fungal infection that can compromise the patient's quality of life. It is associated with dry mouth, burning mouth and even pneumonia, due to the dissemination of the fungus through the upper airways. The treatment of oral candidiasis ranges from the use of drugs that aim to strengthen the immune system, to antifungals in the oral solution, pills and even oral patches forms. Despite the various therapeutic modalities, there is no consensus in the literature about the most effective way to treat this important side effect of anti-neoplastic therapy. AIM: Review the literature on optimal treatment for oral candidiasis in patients with head and neck cancer. METHODOLOGY: A literature review was carried out with international articles published and available in the databases of PubMed, Lilacs and SciELO. The inclusion criteria for the articles were clinical trials, cohort studies; case-control studies; case reports and case series on candidiasis in patients with head and neck cancer. Were included studies published between 2011 and 2022. The description used for the search were in English: oral candidiasis; head; neck cancer; oral cancer; pharyngeal cancer. RESULTS: Few articles were found that clinically evaluated the effectiveness of antifungals, in general, the studies indicate that fluconazole serves as the first option in the treatment of oral candidiasis in patients with head and neck cancer. CONCLUSION: The present literature review indicates a lack of clinical studies on the effectiveness of different antifungals for the treatment of oral candidiasis, the available results suggest that the antifungal fluconazole can be used in a prophylactic and therapeutic way.