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Temporal course and predictive factors of analgesic opioid requirement for chemoradiation‐induced oral mucositis in oropharyngeal cancer
Author(s) -
Alfieri Salvatore,
Ripamonti Carla I.,
Marceglia Sara,
Orlandi Ester,
Iacovelli Nicola A.,
Granata Roberta,
Cavallo Anna,
Pozzi Paolo,
Boffi Roberto,
Bergamini Cristiana,
Imbimbo Martina,
Pala Laura,
Resteghini Carlo,
Mirabile Aurora,
Locati Laura D.,
Licitra Lisa,
Bossi Paolo
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24272
Subject(s) - medicine , mucositis , opioid , morphine , head and neck cancer , chemoradiotherapy , cancer , anesthesia , analgesic , radiation therapy , oncology , receptor
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