Management of oropharyngeal mycosis in head and neck cancer occurring during (chemo) radiotherapy: An Italian radio-oncologist survey

Liliana Belgioia, Almalina Bacigalupo, Daniela Alterio, Elvio Russi, Renzo Corvò

Research output: Contribution to journalArticlepeer-review


Aims and Background: Oropharyngeal candidiasis is a common disorder in head and neck cancer patients (HNCPs) who underwent (chemo)-radiotherapy. An Italian survey was conducted in order to investigate radiation oncologists' behavior in regard to diagnosis, prevention, and treatment of oral candidiasis. Methods and Study design: Between April and May 2013, a national online 18-question survey was sent to major Italian radiotherapy centers. Results: All Italian regions were represented and 86 radiation oncologists were involved. Eighty-three percent of responders estimated that oropharyngeal candidiasis occurred in 30%-40% of their HNCPs. The majority of responders were able to recognize oral mycosis when it occurred in a localized pseudomembranous form and all responders agreed with the fact that oral candidiasis was always associated with mucositis. A prophylactic therapy was prescribed occasionally by 35% and routinely by 20% of responders. Forty percent prescribed an antifungal drug in the case of suspected mycotic infection and 20% waited for symptomatic clinical evidence before prescribing a therapy. In the presence of candidiasis, mainly topical fluconazole (59%) and itraconazole (36%) were prescribed. Concomitant chemo-radiotherapy was first identified as a risk factor for mycosis occurrence and development. Ninety-nine percent of responders believed that oral mycosis was associated with increased toxicity and 44% of them interrupted treatment due to candidiasis. Conclusions: A variety of approaches to oropharyngeal candidiasis emerges from this survey; further clinical trials are necessary to identify the best approach for oral mycosis prevention and treatment and to establish specific international guidelines for HNCPs.

Original languageEnglish
Pages (from-to)312-317
Number of pages6
Issue number3
Publication statusPublished - May 1 2015


  • Head and neck cancer
  • Oropharyngeal candidiasis
  • Prevention and treatment

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)


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