AI Article Synopsis
- Many head and neck cancer patients receiving radiotherapy experience xerostomia (dry mouth) and hyposalivation (reduced saliva production), which increases their risk of opportunistic infections like oral candidiasis due to reduced antimicrobial properties of saliva.
- A literature review reveals that a significant number of these patients show high levels of Candida colonization and many develop oropharyngeal candidiasis, posing risks of serious systemic infections, particularly as non-albicans species and drug-resistant infections become more common.
- The review highlights the need for further research into the interactions between the oral microbiome and Candida, as well as better understanding of xerostomia and hyposalivation, to develop effective long-term management strategies and therapies for these patients.
Article Abstract
Objective: Head and Neck Cancer (HNC) patients receiving radiotherapy (RT) often suffer from xerostomia and/or hyposalivation. As saliva plays an important antimicrobial and cleansing roles, these patients are at higher risks of opportunistic infections. This narrative review aims to provide an overview of current evidence on oral Candida colonisation and infection in these patients.
Methods: A literature review of clinical studies on oral Candida colonisation and candidiasis in HNC patients receiving radiotherapy/chemoradiotherapy was conducted.
Results: Many clinical studies found high levels of Candida colonisation and a substantial proportion of post-RT HNC patients suffering from oropharyngeal candidiasis (OPC). Importantly, oral Candida could be a reservoir for life-threatening systemic infection in immunocompromised patients. The rising prevalence of non-albicans Candida species and drug-resistant infections has made identification of Candida species and antifungal susceptibility more important. Recent advances in oral microbiome and its interactions with Candida are discussed. This review also offers perspectives on limitations of current evidence and suggestions for future research.
Conclusion: Further research to better understand Candida carriage, microbiome, OPC, and xerostomia/hyposalivation post-RT would aid in devising a more comprehensive long-term management plan and novel therapeutic approaches for HNC patients to achieve the full benefits of RT while minimising side effects.
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| http://dx.doi.org/10.1111/odi.15060 | DOI Listing |
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