Neuropathic and nociceptive pain in head and neck cancer patients receiving radiation therapy

Epstein, Joel B.; Wilkie, Diana J.; Fischer, Dena J.; Kim, Young‐Ok; Villines, Dana

doi:10.1186/1758-3284-1-26

Cited by 127 publications

(128 citation statements)

References 75 publications

(78 reference statements)

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“…However, in this study the intervention between TQ1 and TQ2 in fact appeared to be treatment with systemic analgesics due to nociceptive pain. Enough attention was possibly not directed to different current and expected pain mechanisms [3,11,25]. We agree with the recent publications [3,11,25] suggesting use of adjuvant medication more frequently and earlier in OM development in order to attain improved pain relief.…”

Section: Discussionsupporting

confidence: 76%

“…Enough attention was possibly not directed to different current and expected pain mechanisms [3,11,25]. We agree with the recent publications [3,11,25] suggesting use of adjuvant medication more frequently and earlier in OM development in order to attain improved pain relief. In a recent study Bar Ad et al (2009) [27] stated, that gabapentin appeared to be promising in reducing the need of opioids for patients with OM pain, which indicates that the role of gabapentin in OM pain therapy ought to be studied.…”

Section: Discussionsupporting

confidence: 76%

“…Also in three recent clinical studies on different aspects of OM insufficient pain relief with systemic analgesics is mentioned [24][25][26]. However, the advantage of this study -a structured individualized intervention with acetaminophen, NSAID, opioids, and topical anaestheticsis that it clearly, for the first time to our knowledge, illustrates extensive difficulties achieving improved pain relief for the patient group studied (Tables 4 and 5).…”

Section: Discussionmentioning

confidence: 93%

“…It is well known that nociceptive and inflammatory mechanisms are involved in OM pain [3,11,25]. Treatment of nociceptive pain mostly can be performed with a straightforward design.…”

Section: Discussionmentioning

confidence: 99%

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Individualized pharmacological treatment of oral mucositis pain in patients with head and neck cancer receiving radiotherapy

Ling

Larsson

2010

Support Care Cancer

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Results: Worsening of soreness in mouth and overall worsening of swallowing difficulties were seen in the patients referred within the third week of radiotherapy, showing increased severity of OM during the current week (n=59). Pain and swallowing difficulties were unchanged in patients referred later than the third week, showing unchanged severity of OM during the current week (n=23). Conclusion:The answers to the questionnaire showed that the individualized pain treatment with systemic analgesics exploited to the highest degree was insufficient. Future development of pharmacological possibilities for treatment of OM related pain is urgent. In addition, development of structured nursing care and patient selfcare can contribute to improved pain relief.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 93%

“…It is well known that nociceptive and inflammatory mechanisms are involved in OM pain [3,11,25]. Treatment of nociceptive pain mostly can be performed with a straightforward design.…”

Section: Discussionmentioning

confidence: 99%

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Individualized pharmacological treatment of oral mucositis pain in patients with head and neck cancer receiving radiotherapy

Ling

Larsson

2010

Support Care Cancer

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“…[178][179][180][181] Mucositis pain usually begins within 3 weeks of the start of RT, peaks at weeks 5 through 7, and persists for several weeks to months following therapy. [182][183][184][185] Mucositis pain interferes with daily activities in approximately one-third of patients, 54,77,178,179,186,187 affecting mood in 50% to 60% of these patients. 185 Opioid analgesics represent the primary medication for the management of pain due to cancer and its treatment.…”

Section: 145mentioning

confidence: 99%

Oral complications of cancer and cancer therapy

Epstein

Thariat

Bensadoun

et al. 2012

CA A Cancer J Clinicians

411

356

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Answer questions and earn CME/CNEOral complications resulting from cancer and cancer therapies cause acute and late toxicities that may be underreported, underrecognized, and undertreated. Recent advances in cancer treatment have led to changes in the incidence, nature, and severity of oral complications. As the number of survivors increases, it is becoming increasingly recognized that the aggressive management of oral toxicities is needed to ensure optimal long‐term oral health and general well‐being. Advances in care have had an impact on previously recognized oral complications and are leading to newly recognized adverse effects. Here, the authors briefly review advances in cancer therapy, including recent advances in surgery, oral care, radiation therapy, hematopoietic cell transplantation, and medical oncology; describe how these advances affect oral health; and discuss the frequent and/or severe oral health complications associated with cancer and cancer treatment and their effect upon long‐term health. Although some of the acute oral toxicities of cancer therapies may be reduced, they remain essentially unavoidable. The significant impact of long‐term complications requires increased awareness and recognition to promote prevention and appropriate intervention. It is therefore important for the primary oncologist to be aware of these complications so that appropriate measures can be implemented in a timely manner. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time. CA Cancer J Clin 2012. © 2012 American Cancer Society.

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Postoperative Pain Treatment With Continuous Local Anesthetic Wound Infusion in Patients With Head and Neck Cancer

Gostian

Loeser

Albert

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Up to 80% of patients with head and neck cancer undergoing ablative surgery and neck dissection develop postoperative pain with detrimental effects on quality of life that also contributes to neuropathic and chronic postoperative pain.OBJECTIVE To investigate the association of continuous local anesthetic wound infusion with pain management after head and neck surgery.DESIGN, SETTING, AND PARTICIPANTS This prospective, longitudinal, nonrandomized clinical study carried out in a single tertiary referral center (December 1, 2015, to July 1, 2017) included 2 groups of 30 patients. Patients were consecutively enrolled and presented for ablative head and neck surgery including selective neck dissection and studied from the preoperative through the fourth postoperative day. INTERVENTIONSThe control group was treated according to a standardized escalating oral treatment protocol (ibuprofen, metamizole, opioids). The intervention group was treated with an intraoperatively applied pain catheter (InfiltraLong plus FuserPump, Pajunk, ropivacaine, 0.2%, 3 mL/h) that was removed 72 hours after operating. MAIN OUTCOMES AND MEASURESAverage and maximum pain intensities on a numeric rating scale; quality of life using the acute version of the validated 36-Item Short Form Survey; and neuropathic pain using the validated 12-Item painDETECT questionnaire. Consumption of opioid and nonopioid analgesics and evaluation of catheter-associated complications. RESULTS Duringpostoperative days 1 through 4, patients of the intervention group (mean [SD] age, 63.2 [13.3 years; 9 [30%] women) experienced lower mean (SD) (1.6 [1.4] vs 2.7 [1.8]; η 2 p = 0.09 [0.01-0.21]) and maximum (2.4 [2.2] vs 4.2 [2.0]; η 2 p = 0.11 [0.01-0.24]) pain intensities compared with the control group (mean [SD] age, 62.5 [13.6] years; 5 [17%]women). The intervention group also reported less neuropathic pain (mean [SD], 5.4 [3.4] vs 7.6 [5.1]; η 2 p = 0.09 [0.004 -0.22]) and higher quality of life regarding vitality (56.2 [21.5] vs 43.8 [20.9], r = 0.29; 95% CI, 0.01-0.52) and pain (66.8 [27.3] vs 49.5 [27.7], r = 0.31; 95% CI, 0.04-0.54). Patients from the intervention group requested nonopioid analgesics considerably less often (n = 17 [57% ]vs n = 29 [97%]; = 0.47; 95% CI, 0.30-0.67) associated with a noticeably lower need to escalate pain treatment (n = 3 [10%] vs n = 9 [30%]; mean [SD] ibuprofen dose: 500 [173] mg vs 1133 [650] mg; r = 0.64; 95% CI, 0.02-0.91). No catheter-associated complications were observed.CONCLUSIONS AND RELEVANCE Continuous anesthetic wound infusion is associated with reduced postoperative pain and decreased demand for analgesics. It therefore expands the treatment options for postoperative pain in head and neck cancer.

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Neuropathic and nociceptive pain in head and neck cancer patients receiving radiation therapy

Cited by 127 publications

References 75 publications

Individualized pharmacological treatment of oral mucositis pain in patients with head and neck cancer receiving radiotherapy

Individualized pharmacological treatment of oral mucositis pain in patients with head and neck cancer receiving radiotherapy

Oral complications of cancer and cancer therapy

Postoperative Pain Treatment With Continuous Local Anesthetic Wound Infusion in Patients With Head and Neck Cancer

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