Pain management during radiotherapy and radiochemotherapy in oropharyngeal cancer patients: single-institution experience

Int Dent J. 2015 Oct;65(5):242-8. doi: 10.1111/idj.12181. Epub 2015 Sep 12.

Abstract

Aim of the study: Radiotherapy (RT) is a radical therapeutic option for patients with oropharyngeal cancer (OPC). It induces an acute postradiation reaction that may cause significant pain. The aim of this study was to analyse pain occurrence and intensity, as well as type and effectiveness of analgesic treatment, in OPC patients undergoing RT or radiochemotherapy (RT-CT).

Material and methods: Retrospective data were obtained for 42 OPC patients at clinical stages I-IVA, treated with adjuvant RT or RT-CT or definite RT or RT-CcT at the Comprehensive Cancer Center in Bialystok, Poland. Pain intensity and type of analgesic treatment during the therapy were analysed and compared with the intensity of the radiation-induced acute reaction, assessed weekly according to the Dische score.

Results: Thirty-nine (92.9%) patients received analgesic treatment. Analgesic therapy was started in 27 (64.3%) patients with administration of non-steroidal anti-inflammatory drugs (NSAIDs) and/or paracetamol, in seven (16.7%) with mild opioids and in five (11.9%) with strong opioids. Strong opioids were used during therapy in 21 (50%) patients. Co-analgesics were administered to six patients. Breakthrough pain was observed in 10 (23.8%) patients.

Conclusions: High incidence of pain during RT and RT-CT calls for increased awareness of the importance of pain monitoring and treatment during RT of OPC patients. The analgesic treatment had to be adjusted individually.

Keywords: Pain; oropharyngeal cancer (OPC); radiochemotherapy; radiotherapy.

Publication types

  • Comparative Study

MeSH terms

  • Acetaminophen / therapeutic use
  • Adult
  • Aged
  • Analgesics / therapeutic use
  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Chemoradiotherapy / methods
  • Chemoradiotherapy, Adjuvant
  • Cisplatin / therapeutic use
  • Dipyrone / therapeutic use
  • Drug Combinations
  • Female
  • Fentanyl / therapeutic use
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / radiotherapy*
  • Oropharyngeal Neoplasms / therapy
  • Pain / classification
  • Pain Management / methods*
  • Radiotherapy, Adjuvant
  • Radiotherapy, High-Energy / methods
  • Retrospective Studies
  • Tramadol / therapeutic use

Substances

  • Analgesics
  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antineoplastic Agents
  • Drug Combinations
  • Acetaminophen
  • Tramadol
  • Dipyrone
  • Morphine
  • Cisplatin
  • Fentanyl