Prophylactic gabapentin during head and neck cancer therapy: a systematic review and meta-analysis

Support Care Cancer. 2023 Mar 17;31(4):221. doi: 10.1007/s00520-023-07683-w.

Abstract

Purpose: This review was designed to compile the currently available evidence on the prophylactic use of gabapentin in the head and neck cancer patient population.

Methods: A systematic search was conducted of PubMed, Web of Science, and Google Scholar to identify articles related to the use of prophylactic gabapentin in patients undergoing head and neck cancer therapy. Candidate studies were screened for inclusion and a subsequent bias assessment was conducted by multiple reviewers. Meta-analysis was conducted in cases in which the studies used compatible outcome measures.

Results: Ten studies were identified that met the inclusion criteria and were assessed for bias. Among the four small studies that examined pain prevention, 2 were positive and 2 were inconclusive. Three of the four studies examiniRDng opioid use noted less need for opioids in the treatment arm. Meta-analysis of the pertinent studies showed no difference in feeding tube placement (RD = 0.64%, 95%CI: (- 25.8%, 27.1%), p = 0.962) but substantially less weight loss among those in the treatment arm (p = 0.047).

Conclusion: Prophylactic gabapentin appears to be a promising treatment option for preventing pain, reducing opioids, and reducing weight loss in patients undergoing head and neck cancer therapy. However, the studies on the treatment to date are small and several have a substantial risk of bias.

Keywords: Gabapentin; Head and neck cancer; Meta-analysis; Opioids; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Amines / therapeutic use
  • Analgesics
  • Analgesics, Opioid / therapeutic use
  • Cyclohexanecarboxylic Acids* / therapeutic use
  • Gabapentin / therapeutic use
  • Head and Neck Neoplasms* / drug therapy
  • Humans
  • Pain / drug therapy
  • Weight Loss
  • gamma-Aminobutyric Acid / therapeutic use

Substances

  • Gabapentin
  • Analgesics
  • gamma-Aminobutyric Acid
  • Amines
  • Cyclohexanecarboxylic Acids
  • Analgesics, Opioid