Multicenter phase II study of oral care program for head and neck cancer patients treated with chemoradiotherapy.

Yokota, Tomoya; Konishi, Tetsuhito; Tachibana, Hideki; Yurikusa, Takashi; Hamauchi, Satoshi; Sakai, Kensuke; Nishikawa, Masaya; Sato, Maho; Taguri, Masataka; Morita, Satoshi; Eguchi, Toru; Kubota, Keiichi; Zenda, Sadamoto

doi:10.1200/jco.2015.33.15_suppl.e17003

Cited by 1 publication

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“…Notably, it has been reported that radiationinduced mucositis can be the main reason for unplanned breaks in radiotherapy. Thus, management of oral mucositis in head and neck cancer (HNC) patients treated with concurrent radiotherapy (CRT) is a critical issue as it comprises one of the most common complications leading to unexpected treatment interruption as well as hospitalization, associated with a remarkably worse prognosis (10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

“…Efforts were made to reduce mucositis through supportive therapies such as the oral care program reported by Yokota et al, as well as the implementation of cryotherapy, mucosal protective agents, and lidocaine preparations advocated by the NCCN (11,14). Regarding the use of analgesics, Acetaminophen is primarily used for mild pain, while opioids are used for moderate to severe pain to achieve a high CRT completion rate while managing pain (12,13).…”

Section: Introductionmentioning

confidence: 99%

“…However, the pain caused by CRT usually gradually disappears after the completion of treatment. A phase 2 study, which investigated an oral care program for radiation-induced oral mucositis (functional/ symptomatic), reported that grade 3 oral mucositis was observed in 24.8% and 6.3% at two weeks and four weeks after CRT, respectively (14). In these circumstances, irresponsible opioid administration without consideration of the dynamic course can cause opioidrelated adverse events that are detrimental to the patient.…”

Section: Introductionmentioning

confidence: 99%

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A pharmacist-led opioid de-escalation program after completion of chemoradiotherapy in locally advanced head and neck cancer

Horinouchi,

Enokida,

Suzuki

et al. 2023

Front. Oncol.

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BackgroundPersistent opioid use frequently leads to substantial negative impacts on quality of life, and as the outlook for numerous cancer types continues to improve, these complications become increasingly crucial. It is essential to acknowledge that extended or excessive opioid use may result in adverse effects in patients who completed radiation therapy (RT).MethodsIn this time-series analysis, we compared the outcomes of patients who participated in the pharmacist-led opioid de-escalation (PLODE) program after completing concurrent radiotherapy (CRT) between June 2018 and February 2019 against patients who completed CRT between June 2017 and March 2018 and did not participate in the program.ResultsAmong 61 patients, 16 (26%) used opioids after completing CRT and participated in the PLODE program. Before starting the program, 93 patients completed CRT between June 2017 and March 2018 and 32 (34%) used opioids at CRT completion. These patients were deemed the control group. In the PLODE group, outpatient pharmacist intervention was performed, with 29 total interventions related to opioid use, of which 16 (55%) recommended tapering or discontinuing opioids according to the definition of this program. Patients who participated in the PLODE program discontinued opioids significantly earlier than those in the control group (median time to opioid discontinuation 11 days vs. 24.5 days, p < 0.001). None of the patients in the PLODE group resumed opioid use following discontinuation or escalated opioid dosing due to worsening pain.ConclusionThis study showed the utility of pharmacist-initiated interventions for opioid use in patients with head and neck cancer who had completed CRT.

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