Oral cavity overinfection during non surgical cancer therapies: Review of the literature

Introduction. Oral mucositis represents one of the most frequent acute side effectsduring cancer therapies (chemotherapy and/or radiotherapy). It has been hypothesizedthat microbial (bacteria, fungi) overinfection of oral mucosa may enhance intensity andduration of mucositis. For this reason, a lot of studies have been performed in order toevaluate the efficacy of oral cavity bacterial decontamination and/or prevention andtreatment of oral candidiasis.Patients and methods. A comprehensive search of MEDLINE up to December 2007(with no language restriction) was performed. "Mucositis", "Chemotherapy" and"Radiotherapy" were the key words used.Results. Sixty clinical studies matched the key words listed above. Most papers werefocused on oral cavity bacterial decontamination and prevention and/or treatment of oral candidiasis. Recent international guidelines and critical reviews of literature were alsoconsidered.Conclusion. Available literature data do not support the use of preventive bacterialdecontamination of oral cavity by antimicrobial agents. On the contrary, some evidencesexist that prophylaxis of oral candidiasis with antimicotic agents (like fluconazole) couldto be efficacious to reduce the impact of oral mucositis but further larger randomizedtrials are needed.