title: A systematic review of oral herpetic viral infections in cancer patients: commonly used outcome measures and interventions.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, 14620, USA. selad@urmc.rochester.edu.|Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, 14642, USA. selad@urmc.rochester.edu.
authors.forename: Sharon
authors.initials: S
authors.lastname: Elad
authors.affiliation: Department of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, 14620, USA.|School of Dental Medicine, University at Buffalo, Buffalo, NY, USA.
authors.forename: Vinisha
authors.initials: V
authors.lastname: Ranna
authors.affiliation: College of Medicine and Dentistry, James Cook University, Cairns, Australia.|Menzies Health Institute, Griffith University, Gold Coast, Australia.
authors.forename: Anura
authors.initials: A
authors.lastname: Ariyawardana
authors.affiliation: Oral Medicine Ambulatory, Hematology and Hemotherapy Center, University of Campinas, Campinas, Brazil.
authors.forename: Maria Elvira Pizzigatti
authors.initials: ME
authors.lastname: Correa
authors.affiliation: Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, FFMUSP, São Paulo, Brazil.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Tilly
authors.affiliation: Oral Medicine/Oral Oncology, Oral Pathology and Human Diseases, Griffith University and Menzies Health Institute Queensland, Gold Coast, Australia.|Cancer Services, Haematology and Oncology, Gold Coast University Hospital, Queensland Health, Gold Coast, Queensland, Australia.
authors.forename: Raj G
authors.initials: RG
authors.lastname: Nair
authors.affiliation: Dental Oncology Program, Health Sciences North, North East Cancer Center, Sudbury, ON, Canada.
authors.forename: Tanya
authors.initials: T
authors.lastname: Rouleau
authors.affiliation: School of Dentistry, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Logan
authors.affiliation: Oral and Maxillofacial Medicine and Diagnostic Sciences, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Andres
authors.initials: A
authors.lastname: Pinto
authors.affiliation: Dental Oncology Program, Health Sciences North, North East Cancer Center, Sudbury, ON, Canada.
authors.forename: Veronica
authors.initials: V
authors.lastname: Charette
authors.affiliation: Dental Oncology Program, Health Sciences North, North East Cancer Center, Sudbury, ON, Canada.
authors.forename: Debbie P
authors.initials: DP
authors.lastname: Saunders
authors.affiliation: Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus C, Denmark.|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.
authors.forename: Siri Beier
authors.initials: SB
authors.lastname: Jensen
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D009059:Mouth Diseases / Q000150:complications / Q000188:drug therapy*; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011788:Quality of Life
chemical_list: D000998:Antiviral Agents
keywords: Cancer; Efficacy of intervention; HSV; Herpes virus; Oral viral infection; Outcome measures