nach oben

Erschienen in:

16.11.2016 | Review Article

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

verfasst von: Sharon Elad, Vinisha Ranna, Anura Ariyawardana, Maria Elvira Pizzigatti Correa, Vanessa Tilly, Raj G Nair, Tanya Rouleau, Richard M Logan, Andres Pinto, Veronica Charette, Debbie P Saunders, Siri Beier Jensen, Viral Infections Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO)

Erschienen in: Supportive Care in Cancer | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

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.

Nur mit Berechtigung zugänglich

Chen YK, Hou HA, Chow JM, Chen YC, Hsueh PR, Tien HF (2011) The impact of oral herpes simplex virus infection and candidiasis on chemotherapy-induced oral mucositis among patients with hematological malignancies. European journal of clinical microbiology & infectious diseases 30(6):753–759. doi:10.1007/s10096-010-1148-z

Ruping MJ, Keulertz C, Vehreschild JJ, Lovenich H, Sohngen D, Wieland U, Cornely OA (2011) Association of HSV reactivation and pro-inflammatory cytokine levels with the severity of stomatitis after BEAM chemotherapy and autologous SCT. Support. Care Cancer 19(8):1211–1216. doi:10.1007/s00520-010-0940-8

Sepulveda E, Brethauer U, Rojas J, Fernandez E, Le Fort P (2005) Oral ulcers in children under chemotherapy: clinical characteristics and their relation with herpes simplex virus type 1 and Candida albicans. Med. Oral Patol. Cir. Bucal. 10(Suppl 1):E1–E8

Saral R (1990) Oral complications of cancer therapies. Management of acute viral infections. NCI Monogr. 9:107–110

Schubert MM, Peterson DE, Flournoy N, Meyers JD, Truelove EL (1990) Oral and pharyngeal herpes simplex virus infection after allogeneic bone marrow transplantation: analysis of factors associated with infection. Oral Surg. Oral Med. and Oral Pathol. 70(3):286–293

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 283(15):2008–2012CrossRefPubMed

Elad S, Zadik Y, Hewson I, Hovan A, Correa ME, Logan R, Elting LS, Spijkervet FK, Brennan MT (2010) A systematic review of viral infections associated with oral involvement in cancer patients: a spotlight on Herpesviridea. Support. Care Cancer 18(8):993–1006. doi:10.1007/s00520-010-0900-3

Hadorn DC, Baker D, Hodges JS, Hicks N (1996) Rating the quality of evidence for clinical practice guidelines. J Clin Epidemiol 49(7):749–754CrossRefPubMed

Somerfield M, Padberg J, Pfister D, Bennett C, Recht A, Smith T, Weeks J, Winn R, Durant J (2000) ASCO clinical practice guidelines: process, progress, pitfalls, and prospects. Class Pap Curr Comments 4(4):881–886

10.

Anderson H, Scarffe JH, Sutton RN, Hickmott E, Brigden D, Burke C (1984) Oral acyclovir prophylaxis against herpes simplex virus in non-Hodgkin lymphoma and acute lymphoblastic leukaemia patients receiving remission induction chemotherapy. A randomised double blind, placebo controlled trial. Br J Cancer 50(1):45–49CrossRefPubMedPubMedCentral

11.

Bergmann OJ, Ellermann-Eriksen S, Mogensen SC, Ellegaard J (1995) Acyclovir given as prophylaxis against oral ulcers in acute myeloid leukaemia: randomised, double blind, placebo controlled trial. BMJ (Clinical research ed) 310(6988):1169–1172CrossRef

12.

Bergmann OJ, Mogensen SC, Ellermann-Eriksen S, Ellegaard J (1997) Acyclovir prophylaxis and fever during remission-induction therapy of patients with acute myeloid leukemia: a randomized, double-blind, placebo-controlled trial. J. Clin. Oncol. 15(6):2269–2274

13.

Kawamura K, Wada H, Yamasaki R, Ishihara Y, Sakamoto K, Ashizawa M, Sato M, Machishima T, Terasako K, Kimura SI, Kikuchi M, Nakasone H, Yamazaki R, Kanda J, Kako S, Tanihara A, Nishida J, Kanda Y (2013) Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus disease after allogeneic hematopoietic stem cell transplantation. Transpl. Infect. Dis. 15(5):457–465. doi:10.1111/tid.12118

14.

Rojas de Morales T, Zambrano O, Rivera L, Navas R, Chaparro N, Bernardonni C, Rivera F, Fonseca N, Tirado DM (2001) Oral-disease prevention in children with cancer: testing preventive protocol effectiveness. Med. Oral 6(5):326–334

15.

Bergmann OJ, Mogensen SC, Ellegaard J (1990) Herpes simplex virus and intraoral ulcers in immunocompromised patients with haematologic malignancies. European journal of clinical microbiology & infectious diseases 9(3):184–190

16.

Chandrasekar PH, Abraham OC, Klein J, Alangaden G, Chalasani G, Cassells L, Dansey R, Abella S, Karanes C, Peters W, Baynes R (2001) Low infectious morbidity after intensive chemotherapy and autologous peripheral blood progenitor cell transplantation in the outpatient setting for women with breast cancer. Clin. Infect. Dis. 32(4):546–551. doi:10.1086/318715

17.

Djuric M, Jankovic L, Jovanovic T, Pavlica D, Brkic S, Knezevic A, Markovic D, Milasin J (2009) Prevalence of oral herpes simplex virus reactivation in cancer patients: a comparison of different techniques of viral detection. J. Oral Pathol. Med. 38(2):167–173. doi:10.1111/j.1600-0714.2008.00684.x

18.

Gomez RS, Carneiro MA, Souza LN, Victoria JM, de Azevedo WM, De Marco L, Kalapothakis E (2001) Oral recurrent human herpes virus infection and bone marrow transplantation survival. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 91(5):552–556. doi:10.1067/moe.2001.112568

19.

Lloid ME, Schubert MM, Myerson D, Bowden R, Meyers JD, Hackman RC (1994) Cytomegalovirus infection of the tongue following marrow transplantation. Bone Marrow Transplant 14(1):99–104PubMed

20.

Redding SW, Luce EB, Boren MW (1990) Oral herpes simplex virus infection in patients receiving head and neck radiation. Oral Surg. Oral Med. Oral Pathol. 69(5):578–580

21.

Beattie G, Whelan J, Cassidy J, Milne L, Burns S, Leonard R (1989) Herpes simplex virus, Candida albicans and mouth ulcers in neutropenic patients with non-haematological malignancy. Cancer Chemother Pharmacol 25(1):75–76CrossRefPubMed

22.

Epstein JB, Gorsky M, Hancock P, Peters N, Sherlock CH (2002) The prevalence of herpes simplex virus shedding and infection in the oral cavity of seropositive patients undergoing head and neck radiation therapy. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 94(6):712–716. doi:10.1067/moe.2002.127585

23.

Guimaraes AL, Gomes CC, da Silva LM, Correia-Silva Jde F, Victoria JM, Gomez RS, Bittencourt H (2009) Association between oral HSV-1 and survival in allogeneic hematopoietic stem cell transplanted patients. Med. Oral Patol. Oral Cir. Bucal. 14(2):E62–E68

24.

Dreizen S, Bodey GP, Valdivieso M (1983) Chemotherapy-associated oral infections in adults with solid tumors. Oral Surg. Oral Med. Oral Pathol. 55(2):113–120

25.

Nicolatou-Galitis O, Kouloulias V, Sotiropoulou-Lountou A, Dardoufas K, Polychronopoulou AP, Athanassiadou P, Kolitsi G, Kouvaris J (2011) Oral mucositis, pain and xerostomia in 135 head and neck cancer patients receiving radiotherapy with or without chemotherapy. The Open Cancer Journal 4 (1)

26.

Ramirez-Amador V, Esquivel-Pedraza L, Mohar A, Reynoso-Gomez E, Volkow-Fernandez P, Guarner J, Sanchez-Mejorada G (1996) Chemotherapy-associated oral mucosal lesions in patients with leukaemia or lymphoma. Eur J Cancer B Oral Oncol 32b(5):322–327CrossRefPubMed

27.

Barrett AP (1986) A long-term prospective clinical study of orofacial herpes simplex virus infection in acute leukemia. Oral Surg. Oral Med. Oral Pathol. 61(2):149–152

28.

Eisen D, Essell J, Broun ER, Sigmund D, DeVoe M (2003) Clinical utility of oral valacyclovir compared with oral acyclovir for the prevention of herpes simplex virus mucositis following autologous bone marrow transplantation or stem cell rescue therapy. Bone Marrow Transplant 31(1):51–55. doi:10.1038/sj.bmt.1703817 CrossRefPubMed

29.

Engelhard D, Morag A, Or R, Naparstek E, Cividalli G, Ruchlemer R, Aker M, Maayan S, Slavin S (1988) Prevention of herpes simplex virus (HSV) infection in recipients of HLA-matched T-lymphocyte-depleted bone marrow allografts. Isr J Med Sci 24(3):145–150PubMed

30.

Epstein JB, Sherlock C, Page JL, Spinelli J, Phillips G (1990) Clinical study of herpes simplex virus infection in leukemia. Oral Surg. Oral Med. Oral Pathol. 70(1):38–43

31.

Orlowski RZ, Mills SR, Hartley EE, Ye X, Piantadosi S, Ambinder RF, Gore SD, Miller CB (2004) Oral valacyclovir as prophylaxis against herpes simplex virus reactivation during high dose chemotherapy for leukemia. Leuk. Lymphoma 45(11):2215–2219. doi:10.1080/10428190410001733763

32.

Saral R, Ambinder RF, Burns WH, Angelopulos CM, Griffin DE, Burke PJ, Lietman PS (1983) Acyclovir prophylaxis against herpes simplex virus infection in patients with leukemia. A randomized, double-blind, placebo-controlled study. Ann Intern Med 99(6):773–776CrossRefPubMed

33.

Saral R, Burns WH, Laskin OL, Santos GW, Lietman PS (1981) Acyclovir prophylaxis of herpes-simplex-virus infections. N Engl J Med 305(2):63–67. doi:10.1056/nejm198107093050202 CrossRefPubMed

34.

Shepp DH, Dandliker PS, Flournoy N, Meyers JD (1987) Sequential intravenous and twice-daily oral acyclovir for extended prophylaxis of herpes simplex virus infection in marrow transplant patients. Transplantation 43(5):654–658CrossRefPubMed

35.

Warkentin DI, Epstein JB, Campbell LM, Yip JG, Cox VC, Ransier A, Barnett MJ, Marra F (2002) Valacyclovir versus acyclovir for HSV prophylaxisin neutropenic patients. Ann Pharmacother 36(10):1525–1531CrossRefPubMed

36.

Gluckman E, Lotsberg J, Devergie A, Zhao XM, Melo R, Gomez-Morales M, Mazeron MC, Perol Y (1983) Oral acyclovir prophylactic treatment of herpes simplex infection after bone marrow transplantation. J Antimicrob Chemother 12(Suppl B):161–167CrossRefPubMed

37.

Liesveld JL, Abboud CN, Ifthikharuddin JJ, Lancet JE, Wedow LA, Oliva J, Stamm CG, Nichols D (2002) Oral valacyclovir versus intravenous acyclovir in preventing herpes simplex virus infections in autologous stem cell transplant recipients. Biol. Blood Marrow Transplant. 8(12):662–665

38.

Wade JC, Newton B, Flournoy N, Meyers JD (1984) Oral acyclovir for prevention of herpes simplex virus reactivation after marrow transplantation. Ann Intern Med 100(6):823–828CrossRefPubMed

39.

Carrega G, Castagnola E, Canessa A, Argenta P, Haupt R, Dini G, Garaventa A (1994) Herpes simplex virus and oral mucositis in children with cancer. Support. Care Cancer 2(4):266–269

40.

Shepp DH, Newton BA, Dandliker PS, Flournoy N, Meyers JD (1985) Oral acyclovir therapy for mucocutaneous herpes simplex virus infections in immunocompromised marrow transplant recipients. Ann Intern Med 102(6):783–785CrossRefPubMed

41.

Wade JC, Newton B, McLaren C, Flournoy N, Keeney RE, Meyers JD (1982) Intravenous acyclovir to treat mucocutaneous herpes simplex virus infection after marrow transplantation: a double-blind trial. Ann Intern Med 96(3):265–269CrossRefPubMed

42.

Mitchell CD, Bean B, Gentry SR, Groth KE, Boen JR, Balfour HH Jr (1981) Acyclovir therapy for mucocutaneous herpes simplex infections in immunocompromised patients. Lancet (London, England) 1(8235):1389–1392CrossRef

43.

Nicolatou-Galitis O, Athanassiadou P, Kouloulias V, Sotiropoulou-Lontou A, Dardoufas K, Polychronopoulou A, Gonidi M, Kyprianou K, Kolitsi G, Skarleas C, Pissakas G, Papanikolaou IS, Kouvaris J (2006) Herpes simplex virus-1 (HSV-1) infection in radiation-induced oral mucositis. Support. Care Cancer 14(7):753–762. doi:10.1007/s00520-005-0006-5

44.

Nicolatou-Galitis O, Dardoufas K, Markoulatos P, Sotiropoulou-Lontou A, Kyprianou K, Kolitsi G, Pissakas G, Skarleas C, Kouloulias V, Papanicolaou V, Legakis NJ, Velegraki A (2001) Oral pseudomembranous candidiasis, herpes simplex virus-1 infection, and oral mucositis in head and neck cancer patients receiving radiotherapy and granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash. J. Oral Pathol. Med. 30(8):471–480

45.

Tricot G, De Clercq E, Boogaerts MA, Verwilghen RL (1986) Oral bromovinyldeoxyuridine therapy for herpes simplex and varicella-zoster virus infections in severely immunosuppressed patients: a preliminary clinical trial. J Med Virol 18(1):11–20CrossRefPubMed

46.

Hann IM, Prentice HG, Blacklock HA, Ross MG, Brigden D, Rosling AE, Burke C, Crawford DH, Brumfitt W, Hoffbrand AV (1983) Acyclovir prophylaxis against herpes virus infections in severely immunocompromised patients: randomised double blind trial. Br Med J (Clin Res Ed) 287(6389):384–388CrossRef

47.

van der Beek MT, Laheij AM, Raber-Durlacher JE, von dem Borne PA, Wolterbeek R, van der Blij-de Brouwer CS, van Loveren C, Claas EC, Kroes AC, de Soet JJ, Vossen AC (2012) Viral loads and antiviral resistance of herpesviruses and oral ulcerations in hematopoietic stem cell transplant recipients. Bone Marrow Transplant 47(9):1222–1228. doi:10.1038/bmt.2012.2 CrossRefPubMed

48.

Appendices (2009). Bone marrow transplantation 44 (8):527–536

49.

Tomblyn M, Chiller T, Einsele H, Gress R, Sepkowitz K, Storek J, Wingard JR, Young JA, Boeckh MJ (2009) Guidelines for preventing infectious complications among hematopoietic cell transplant recipients: a global perspective. Preface. Bone Marrow Transplant. 44(8):453–455. doi:10.1038/bmt.2009.254

50.

Zaia J, Baden L, Boeckh MJ, Chakrabarti S, Einsele H, Ljungman P, McDonald GB, Hirsch H (2009) Viral disease prevention after hematopoietic cell transplantation. Bone Marrow Transplant 44(8):471–482CrossRefPubMed

51.

Kim JH, Schaenman JM, Ho DY, Brown JM (2011) Treatment of acyclovir-resistant herpes simplex virus with continuous infusion of high-dose acyclovir in hematopoietic cell transplant patients. Biol. Blood Marrow Transplant. 17(2):259–264. doi:10.1016/j.bbmt.2010.06.020

52.

Varella RB, Guimaraes MA, Guimaraes AC, Atalla A, Nucci M, Ramos-e-Silva M (2012) Acyclovir susceptibility of herpes simplex virus isolates from transplanted and nontransplanted patients in Rio de Janeiro, Brazil. Skinmed 10(4):208–211PubMed

53.

Andrei G, Georgala A, Topalis D, Fiten P, Aoun M, Opdenakker G, Snoeck R (2013) Heterogeneity and evolution of thymidine kinase and DNA polymerase mutants of herpes simplex virus type 1: implications for antiviral therapy. J. Infect. Dis. 207(8):1295–1305. doi:10.1093/infdis/jit019

54.

Bacon TH, Levin MJ, Leary JJ, Sarisky RT, Sutton D (2003) Herpes simplex virus resistance to acyclovir and penciclovir after two decades of antiviral therapy. Clin Microbiol Rev 16(1):114–128

55.

Erard V, Wald A, Corey L, Leisenring WM, Boeckh M (2007) Use of long-term suppressive acyclovir after hematopoietic stem-cell transplantation: impact on herpes simplex virus (HSV) disease and drug-resistant HSV disease. J. Infect. Dis. 196(2):266–270. doi:10.1086/518938

56.

Nichols WG, Boeckh M, Carter RA, Wald A, Corey L (2003) Transferred herpes simplex virus immunity after stem-cell transplantation: clinical implications. J. Infect. Dis. 187(5):801–808. doi:10.1086/367894

57.

Langston AA, Redei I, Caliendo AM, Somani J, Hutcherson D, Lonial S, Bucur S, Cherry J, Allen A, Waller EK (2002) Development of drug-resistant herpes simplex virus infection after haploidentical hematopoietic progenitor cell transplantation. Blood 99(3):1085–1088CrossRefPubMed

58.

Eckle T, Prix L, Jahn G, Klingebiel T, Handgretinger R, Selle B, Hamprecht K (2000) Drug-resistant human cytomegalovirus infection in children after allogeneic stem cell transplantation may have different clinical outcomes. Blood 96(9):3286–3289PubMed

59.

Reusser P, Einsele H, Lee J, Volin L, Rovira M, Engelhard D, Finke J, Cordonnier C, Link H, Ljungman P (2002) Randomized multicenter trial of foscarnet versus ganciclovir for preemptive therapy of cytomegalovirus infection after allogeneic stem cell transplantation. Blood 99(4):1159–1164CrossRefPubMed

60.

Cesaro S, Zhou X, Manzardo C, Buonfrate D, Cusinato R, Tridello G, Mengoli C, Palu G, Messina C (2005) Cidofovir for cytomegalovirus reactivation in pediatric patients after hematopoietic stem cell transplantation. J. Clin. Virol. 34(2):129–132. doi:10.1016/j.jcv.2005.02.009

61.

Platzbecker U, Bandt D, Thiede C, Helwig A, Freiberg-Richter J, Schuler U, Plettig R, Geissler G, Rethwilm A, Ehninger G, Bornhauser M (2001) Successful preemptive cidofovir treatment for CMV antigenemia after dose-reduced conditioning and allogeneic blood stem cell transplantation. Transplantation 71(7):880–885CrossRefPubMed

62.

Ljungman P, Deliliers GL, Platzbecker U, Matthes-Martin S, Bacigalupo A, Einsele H, Ullmann J, Musso M, Trenschel R, Ribaud P, Bornhauser M, Cesaro S, Crooks B, Dekker A, Gratecos N, Klingebiel T, Tagliaferri E, Ullmann AJ, Wacker P, Cordonnier C (2001) Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients. The infectious diseases working Party of the European Group for blood and marrow transplantation. Blood 97(2):388–392CrossRefPubMed

63.

Rinaldo CH, Gosert R, Bernhoff E, Finstad S, Hirsch HH (2010) 1-O-hexadecyloxypropyl cidofovir (CMX001) effectively inhibits polyomavirus BK replication in primary human renal tubular epithelial cells. Antimicrob Agents Chemother 54(11):4714–4722. doi:10.1128/aac.00974-10 CrossRefPubMedPubMedCentral

64.

Marty FM, Winston DJ, Rowley SD, Vance E, Papanicolaou GA, Mullane KM, Brundage TM, Robertson AT, Godkin S, Mommeja-Marin H, Boeckh M (2013) CMX001 to prevent cytomegalovirus disease in hematopoietic-cell transplantation. N Engl J Med 369(13):1227–1236. doi:10.1056/NEJMoa1303688 CrossRefPubMed

65.

Whitley RJ, Prichard M (2014) A novel potential therapy for HSV. N Engl J Med 370(3):273–274. doi:10.1056/NEJMe1313982 CrossRefPubMed

66.

Vere Hodge RA, Field HJ (2013) Antiviral agents for herpes simplex virus. Adv. Pharmacol. (San Diego, Calif) 67:1–38. doi:10.1016/b978-0-12-405880-4.00001-9

Titel: A systematic review of oral herpetic viral infections in cancer patients: commonly used outcome measures and interventions
verfasst von: Sharon Elad
Vinisha Ranna
Anura Ariyawardana
Maria Elvira Pizzigatti Correa
Vanessa Tilly
Raj G Nair
Tanya Rouleau
Richard M Logan
Andres Pinto
Veronica Charette
Debbie P Saunders
Siri Beier Jensen
Viral Infections Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO)
Publikationsdatum: 16.11.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 2/2017
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-016-3477-7

Neu im Fachgebiet Onkologie

23.04.2024 | Medikamente in Schwangerschaft und Stillzeit | Nachrichten

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

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

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Onkologie

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

Müde im Alter? Auch an die Nebenniere denken

Stufenschema weist Prostatakarzinom zuverlässig nach

Update Onkologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2017

The use of opioids in cancer patients with renal impairment—a systematic review

Comparison of symptom clusters associated with fatigue in older and younger survivors of colorectal cancer

Impact of antibacterial prophylaxis during reinduction chemotherapy for relapse/refractory acute myeloid leukemia

Psychometric properties and measurement equivalence of the English and Chinese versions of the Beck Anxiety Inventory in patients with breast cancer

The impact of a simplified documentation method for the Edmonton classification system for cancer pain (ECS-CP) on clinician utilization

A qualitative exploration of oncology nurses’ family assessment practices in Denmark and Australia

Neu im Fachgebiet Onkologie

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

Müde im Alter? Auch an die Nebenniere denken

Stufenschema weist Prostatakarzinom zuverlässig nach

Update Onkologie