Abstract
e20590 Background: Oropharyngeal candidiasis (OPC) is usually considered as a frequent and manageable complication of cancer treatments. International guidelines recommend the use of broad spectrum local antifungal agents as first line treatment using old published data. In 2008, we elaborated a prospective pharmaco- epidemiological survey (Candidoscope) to update the prevalence and the management of OPC in France. Methods: Candidoscope concerned patients suffering from solid tumors or non-Hodgkin's lymphoma (NHL) and still under treatments. Thirty-five French centres participated in this survey. Patients were screened during a consecutive period of 15 days and were included in a registry to estimate OPC prevalence. Exclusion criteria was the use of antifungal agents within the last 15 days before the beginning of the the present study. OPC was defined clinically. Patients diagnosed for OPC were selected to the second part of the study detailing OPC treatments. Results: Overall, 2,027 patients were registered. OPC prevalence was 9.6% (n=195). Breast cancer population was the most frequent disease presenting untreated OPC (n= 47, 24%). The prevalence of OPC in head and neck, digestive cancer, and NHL patients was 30%, 20%, and 20%, respectively. Patients with combined treatments presented the highest OPC prevalence (nearly 22%). The most common clinical presentation for OPC was the erythematous form (62%). Main OPC symptoms were dry mouth (63%), altered taste (60%), pain (43%), dysphagia (42%), and appetite disorders (31%) with an average weight loss of 4kg. Local antifungal agents (amphotericin B, nystatin, and miconazole muco-adhesive buccal tablet (MBT)) were given in 75% of patients (41%, 12%, and 22%, respectively). Compliance to treatment was respectively 19%, 40%, and 88% for nystatin, amphotericin B with mouthwashes, and MBT. Conclusions: The prevalence of OPC in treated cancer patients is frequent with important clinical consequences. Systemic treatment compliance delivered according to the international guidelines is often poor and are strongly improved by the use of daily MBT. No significant financial relationships to disclose.
Published Version
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