Temporal course and predictive factors of analgesic opioid requirement for chemoradiation-induced oral mucositis in oropharyngeal cancer.

Abstract

BACKGROUND:

Oral mucositis (OM)-related pain affects most patients with head and neck cancer during treatments, but its management is not standardized.

METHODS:

We retrospectively collected data about the opioid therapy used for OM-induced pain in all patients with oropharyngeal cancer treated with chemoradiotherapy (CRT) between 2009 and 2013. To compare the different opioids, a conversion into oral morphine equivalent daily dose (OMEDD) was performed. The highest OMEDD (h-OMEDD) and the opioids' weekly increase were associated with patient, tumor, or treatment-related characteristics in order to identify predictive factors of opioid consumption.

RESULTS:

Ninety-seven percent of patients received opioids. The h-OMEDD was significantly correlated with a higher OM-grade and a lower smoking history. The weekly opioids' increase was higher in patients with lower smoking history and human papillomavirus (HPV) positivity.

CONCLUSION:

Opioid therapy remains the mainstay for OM-related pain management during CRT. The role of previous smoking and HPV on opioid use needs further confirmations. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1521-E1527, 2016.

• Authors: Salvatore Alfieri, Carla I Ripamonti, Sara Marceglia, Ester Orlandi, Nicola A Iacovelli, Roberta Granata, Anna Cavallo, Paolo Pozzi, Roberto Boffi, Cristiana Bergamini, Martina Imbimbo, Laura Pala, Carlo Resteghini, Aurora Mirabile, Laura D Locati, Lisa Licitra, Paolo Bossi
• Journal: Head & neck (Head Neck) Vol. 38 Suppl 1 Pg. E1521-7 (04 2016) ISSN: 1097-0347 [Electronic] United States
• PMID: 26849016 (Publication Type: Journal Article)
• Copyright: © 2016 Wiley Periodicals, Inc.

Chemical References

• Analgesics
• Analgesics, Opioid

Topics

• Adult
• Aged
• Analgesics (administration & dosage, therapeutic use)
• Analgesics, Opioid (administration & dosage, therapeutic use)
• Chemoradiotherapy (adverse effects)
• Female
• Humans
• Male
• Middle Aged
• Mucositis (chemically induced)
• Oropharyngeal Neoplasms (therapy)
• Smoking