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

Salvatore Alfieri, Carla Ida Ripamonti, Sara Marceglia, Ester Orlandi, Nicola Alessandro Iacovelli, R. Granata, Anna Cavallo, Paolo Pozzi, Roberto Boffi, Cristiana Bergamini, Martina Imbimbo, Laura Pala, Carlo Resteghini, A. Mirabile, Laura Locati, Lisa Licitra, Paolo Bossi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)E1521-E1527
JournalHead and Neck Surgery
Volume38
DOIs
Publication statusPublished - Apr 1 2016

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Oropharyngeal Neoplasms
Stomatitis
Opioid Analgesics
Smoking
Chemoradiotherapy
Morphine
History
Pain
Pain Management
Therapeutics
Head and Neck Neoplasms

Keywords

  • opioids
  • oral mucositis
  • oropharyngeal cancer
  • pain
  • smoking

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Temporal course and predictive factors of analgesic opioid requirement for chemoradiation-induced oral mucositis in oropharyngeal cancer. / Alfieri, Salvatore; Ripamonti, Carla Ida; Marceglia, Sara; Orlandi, Ester; Iacovelli, Nicola Alessandro; Granata, R.; Cavallo, Anna; Pozzi, Paolo; Boffi, Roberto; Bergamini, Cristiana; Imbimbo, Martina; Pala, Laura; Resteghini, Carlo; Mirabile, A.; Locati, Laura; Licitra, Lisa; Bossi, Paolo.

In: Head and Neck Surgery, Vol. 38, 01.04.2016, p. E1521-E1527.

Research output: Contribution to journalArticle

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T1 - Temporal course and predictive factors of analgesic opioid requirement for chemoradiation-induced oral mucositis in oropharyngeal cancer

AU - Alfieri, Salvatore

AU - Ripamonti, Carla Ida

AU - Marceglia, Sara

AU - Orlandi, Ester

AU - Iacovelli, Nicola Alessandro

AU - Granata, R.

AU - Cavallo, Anna

AU - Pozzi, Paolo

AU - Boffi, Roberto

AU - Bergamini, Cristiana

AU - Imbimbo, Martina

AU - Pala, Laura

AU - Resteghini, Carlo

AU - Mirabile, A.

AU - Locati, Laura

AU - Licitra, Lisa

AU - Bossi, Paolo

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N2 - 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.

AB - 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.

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