Perfil microbiológico oral em pacientes com câncer em tratamento e suas aplicações clínicas: uma revisão integrativa

Abstract

Cancer, one of the major global health challenges, and its treatments, such as chemotherapy and radiotherapy, frequently trigger severe oral complications. Among these alterations, oral mucositis and microbiome dysbiosis stand out, which can compromise the effectiveness of cancer treatment, increase the risk of systemic infections, and negatively impact the quality of life and survival of patients. The objective of this research was to evaluate, through an integrative review and meta-analysis, the oral clinical and microbiological profile and its impact on cancer patients, identifying patterns associated with complications and prognosis. Following the PRISMA guidelines, this integrative review included 45 studies (prospective cohorts, clinical trials, cross-sectional and case-control studies) published between 2020 and 2025, identified in databases such as Scopus, Web of Science, and SciELO. Qualitative synthesis and random-effects meta-analysis were performed for specific outcomes. Oral mucositis (OM) was the most prevalent complication (38%-89%), with significantly greater severity in head and neck radiotherapy, especially when associated with chemotherapy (pooled OR = 3.45). Severe OM (grades 3-4) drastically increased the likelihood of treatment interruption or dose reduction (pooled OR = 5.92). Microbial dysbiosis, characterized by reduced alpha diversity and pathogen expansion, was a consistent finding and proved to be an independent risk factor for systemic infections (pooled RR = 2.81). High rates of antimicrobial resistance were documented, such as fluconazole resistance in 45% of Candida glabrata strains. It is concluded that oral complications, especially mucositis and microbial dysbiosis, are interconnected with a direct impact on the effectiveness of cancer treatment and clinical outcomes. Integrating rigorous oral health management into the multidisciplinary oncology team is essential to improve the prognosis and quality of life of patients.