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

Head Neck. 2016 Apr:38 Suppl 1:E1521-7. doi: 10.1002/hed.24272. Epub 2016 Feb 5.

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.

Keywords: opioids; oral mucositis; oropharyngeal cancer; pain; smoking.

MeSH terms

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

Substances

  • Analgesics
  • Analgesics, Opioid