Background
Pain due to oral mucositis (OM) is a major problem during concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) patients.
Methods
We enrolled 56 NPC patients receiving CCRT and allocated them into two groups: moderate pain group (
n
= 27) and a severe pain group (
n
= 29) according to the degree of pain reported (moderate = numerical rating scale (NRS) score 4–6 or severe = NRS score 7–10) at initiation of controlled-release oxycodone (CRO) treatment.
Results
Total dose of CRO was significantly higher in severe pain patients than in moderate pain patients (791.60 ± 332.449 mg vs. 587.27 ± 194.940 mg;
P
= 0.015). Moderate pain patients had significantly better quality of life (
P
= 0.037), lower weight loss (
P
= 0.030) and more active CCRT response (90.9% vs. 64.0%;
P
= 0.041). Although 24-h pain control rate was comparable in the two groups (85.2% vs. 86.2%;
P
= 0.508), the moderate pain group score eventually stabilized at ~ 2 vs. 3 in the severe pain group (
P
< 0.001); the titration time to reach bearable pain (NRS ≤ 3) was also significantly shorter in moderate pain patients (2.45 ± 0.60 days vs. 3.60 ± 1.98 days;
P
= 0.012). Incidence of adverse events was comparable in both groups.
Conclusions
The study findings suggest that early introduction of low-dose CRO at the moderate pain stage could help reduce the total dose required, provide better pain control, improve quality of life, and enhance CCRT response.
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