Pain in Head and Neck Cancer Survivors: Prevalence, Predictors, and Quality‐of‐Life Impact

Cramer, John D.; Johnson, Jonas T.; Nilsen, Marci Lee

doi:10.1177/0194599818783964

Cited by 118 publications

(116 citation statements)

References 25 publications

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“…34,35 In the first 2 years after therapy, the main emphasis of patients and physicians is put on disease control and survival, as the risk of recurrence is highest during this period. 34,35 In the first 2 years after therapy, the main emphasis of patients and physicians is put on disease control and survival, as the risk of recurrence is highest during this period.…”

Section: Discussionmentioning

confidence: 99%

“…Especially for the ±50% survivors after CRT for HNC, VLT is of utmost importance for their QOL. 34,35 In the first 2 years after therapy, the main emphasis of patients and physicians is put on disease control and survival, as the risk of recurrence is highest during this period. Hereafter, the chances for recurrent disease decrease, and patients need to settle themselves in their new status with sometime important permanent side effects following therapy.…”

Section: Discussionmentioning

confidence: 99%

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Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

et al. 2019

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Background Acute and late toxicity after intensity‐modulated radiotherapy (IMRT) for head and neck cancer (HNC) impacts on patient quality of life; yet, very late toxicity data remain scarce. This study assessed dysphagia, xerostomia, and neck fibrosis 3‐8 years after IMRT. Methods A retrospective analysis using generalized estimated equations was performed on 60 patients with HNC treated with fractionated IMRT between 2000 and 2015 who had a follow‐up ≥8 years. Toxicity was scored using LENT‐SOMA scales. Results A trend towards a nonlinear global time effect (P = .05) was noted for dysphagia with a decrease during the 5 years post‐treatment and an increase thereafter. A significant decrease in xerostomia (P = .001) and an increase in neck fibrosis (P = .04) was observed until 8 years. Conclusions Dysphagia, xerostomia, and neck fibrosis do not appear stable over time and remain highly prevalent in the very late follow‐up. Our findings support the need for prospective trials investigating very late toxicity in patients with HNC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

et al. 2019

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“…Because of all the above-mentioned criticisms, assessing the real incidence and severity of chronic pain in long-term HNC survivors is challenging. For this reason, literature data provides a wide range in incidence of chronic pain from 8% to 60% [26,58,59,[61][62][63][64][65].…”

Section: )mentioning

confidence: 99%

“…damage and osteoradionecrosis) and chemotherapy-induced pain (mainly due to peripheral neuropathy)[65] …”

mentioning

confidence: 99%

The point of pain in head and neck cancer

Bossi

Giusti

Tarsitano

et al. 2019

Critical Reviews in Oncology/Hematology

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Head and neck cancer (HNC) can have a devastating impact on patient's lives as both disease and treatment may affect the ability to speak, swallow and breathe. These conditions limit the oral intake of food and drugs, reduce social functioning and impact on patient's quality of life. Up to 80% of patients suffering from HNC have pain due to the spread of the primary tumor, because of consequences of surgery, or by developing oral mucositis, dysphagia or neuropathy as toxic side effects of radiotherapy, chemotherapy or both.All healthcare professionals caring for HNC patients should assess palliative and supportive care needs in initial treatment planning and throughout the disease, with awareness when specialist palliative care expertise is needed. This paper focuses on assessment, characterizations and clinical management of pain in advanced HNC patients undergoing surgery, chemotherapy and radiotherapy, also underlining the importance of symptom assessment in HNC survivors and the need of clinical research in this field. KeywordsHead and neck cancer, Pain, Quality of life, Clinical research [16].

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“…Pain is one of the most problematic acute and late toxicities of radiation therapy for patients with head and neck cancer (HNC). [1][2][3][4] Although there are numerous etiologies for this pain, radiation mucositis has garnered particular attention due to its immediate and profound impact on critical functions such as swallowing, speaking, and handling secretions. 5,6 Preventive and treatment measures have been tested to reduce radiation mucositis and associated pain; however, more effective interventions are needed.…”

Section: Introductionmentioning

confidence: 99%

Preventive use of gabapentin to decrease pain and systemic symptoms in patients with head and neck cancer undergoing chemoradiation

et al. 2020

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Background: Radiation for patients with head and neck cancer (HNC) is associated with painful mucositis that impacts the delivery of treatment and contributes to high symptom burden. Methods: This was a prospective, randomized pilot trial. Eligible patients received primary or adjuvant chemoradiation. Patients were randomized to usual care vs usual care plus gabapentin titrated to drug tolerance during radiation. Patients completed a symptom survey at baseline and weekly during therapy. Results: Seventy-nine patients were enrolled in the study (38 control, 41 treatment). At interim analysis, gabapentin use resulted in a decrease in pain (P = .004), with the biggest decreases being in the latter weeks of therapy. By week 7, the median pain score in the treatment group was below the 0.25 quantile of the control group. Conclusion: Prophylactic use of gabapentin during chemoradiation for HNC patients resulted in a decrease in pain, neurosensory symptoms, and general systemic symptoms.

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Pain in Head and Neck Cancer Survivors: Prevalence, Predictors, and Quality‐of‐Life Impact

Abstract: Years after head and neck cancer treatment, pain remains a significant problem and is associated with worse QOL. Future efforts should focus on preventing pain from treatment and comprehensive management.

Cited by 118 publications

References 25 publications

Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

The point of pain in head and neck cancer

Preventive use of gabapentin to decrease pain and systemic symptoms in patients with head and neck cancer undergoing chemoradiation

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