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A systematic review of oral herpetic viral infections in cancer patients: commonly used outcome measures and interventions

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Abstract

Purpose

To review the literature for outcome measures for oral viral infections in cancer patients. A secondary aim was to update the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) clinical practice guidelines for the management of oral viral infections in cancer patients.

Methods

Databases were searched for articles published in the English language, 1981–2013. Studies that met the eligibility criteria were reviewed systematically. The data about the outcome measures were classified according to the aim of the study: prevention, treatment, or non-interventional. The results of interventional studies were compared to the 2010 MASCC/ISOO publication.

Results

Multiple clinical and laboratory tests were used to measure oral viral infections, with great variability between studies. Most of the studies were about Herpes Simplex Virus (HSV). The outcome measure that was most commonly used was the presence of HSV infection diagnosed based on a combination of suggestive clinical presentation with a positive laboratory result. HSV culture was the most commonly reported laboratory outcome measure. Acyclovir and valacyclovir were consistently reported to be efficacious in the management of oral herpetic infections. No new data on the quality of life and economic aspects was found.

Conclusions

Considering the variability in outcome measures reported to assess oral herpetic infections the researcher should select carefully the appropriate measures based on the objective of the study. Acyclovir and valacyclovir are effective in the management of oral herpetic infections in patients receiving treatment for cancer. Studies on newer anti-viral drugs may be useful to address the issue of anti-viral resistance.

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Acknowledgment

The authors would like to thank Doug Peterson, DMD PhD FDS RCSEd, Oral Health and Diagnostic Sciences, Uconn Health, for reviewing this paper and providing valuable guidance. Additionally, the authors would like to thank Girija Naidu, DDS, Advanced Education in General Dentistry Program, General Dentistry, Eastman Institute for Oral Health, Rochester, NY for her assistance with the early data compilation.

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Authors and Affiliations

  1. Department of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, 14620, USA

    Sharon Elad & Vinisha Ranna

  2. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, 14642, USA

    Sharon Elad

  3. School of Dental Medicine, University at Buffalo, Buffalo, NY, USA

    Vinisha Ranna

  4. College of Medicine and Dentistry, James Cook University, Cairns, Australia

    Anura Ariyawardana

  5. Menzies Health Institute, Griffith University, Gold Coast, Australia

    Anura Ariyawardana

  6. Oral Medicine Ambulatory, Hematology and Hemotherapy Center, University of Campinas, Campinas, Brazil

    Maria Elvira Pizzigatti Correa

  7. Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, FFMUSP, São Paulo, Brazil

    Vanessa Tilly

  8. Oral Medicine/Oral Oncology, Oral Pathology and Human Diseases, Griffith University and Menzies Health Institute Queensland, Gold Coast, Australia

    Raj G Nair

  9. Cancer Services, Haematology and Oncology, Gold Coast University Hospital, Queensland Health, Gold Coast, Queensland, Australia

    Raj G Nair

  10. Dental Oncology Program, Health Sciences North, North East Cancer Center, Sudbury, ON, Canada

    Tanya Rouleau, Veronica Charette & Debbie P Saunders

  11. School of Dentistry, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia

    Richard M Logan

  12. Oral and Maxillofacial Medicine and Diagnostic Sciences, University Hospitals Case Medical Center, Cleveland, OH, USA

    Andres Pinto

  13. Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus C, Denmark

    Siri Beier Jensen

  14. Section of Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Siri Beier Jensen

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  1. Sharon Elad
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  2. Vinisha Ranna
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Viral Infections Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO)

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Correspondence to Sharon Elad.

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Elad, S., Ranna, V., Ariyawardana, A. et al. A systematic review of oral herpetic viral infections in cancer patients: commonly used outcome measures and interventions. Support Care Cancer 25, 687–700 (2017). https://doi.org/10.1007/s00520-016-3477-7

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