Randomized trial of standard pain control with or without gabapentin for pain related to radiation-induced mucositis in head and neck cancer

Kataoka, Tomoko; Kiyota, Naomi; Shimada, Toru; Funakoshi, Yohei; Chayahara, Naoko; Toyoda, Masanori; Fujiwara, Yutaka; Nibu, Ken‐ichi; Komori, Takahide; Sasaki, Ryohei; Mukohara, Toru; Minami, Hironobu

doi:10.1016/j.anl.2016.02.012

Cited by 37 publications

(57 citation statements)

References 30 publications

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“…Keskinbora et al [22] found that combination of gabapentin with morphine for treatment of cancer neuropathic pain could reduce the pain scores in their early studies; while another study concluded that amitriptyline might be more suitable for management of neuropathic pain in cancer patients as adjuvant therapy combined with opioid because of lower cost of amitriptyline. [23] Studies showed that the effectiveness of gabapentin as an adjuvant analgesic added to opioid for cancer pain presents tissue specificity, for example, the combined program had poor beneficial effect for pain related to radiation-induced mucositis in head and neck cancer [24] ; while treatment with gabapentin could be significantly effective and well tolerated in nearly all of the postmastectomy pain syndrome patients, [25] metastatic bone pain, [6] and visceral pain. [7,26] In the present study, the patients in trial group were treated with opioid drugs combined gabapentin, resulting in incensement of the analgesic effect of opioids, which might as well delay its tolerance.…”

Section: Discussionmentioning

confidence: 99%

The research on long-term clinical effects and patients’ satisfaction of gabapentin combined with oxycontin in treatment of severe cancer pain

Chen¹,

Wang

et al. 2016

Medicine

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Gabapentin has been used as an adjuvant for treatment of cancer pain. Previous studies showed that opioids combined with gabapentin for management of cancer pain reduced the dosage of opioids.The objective of this study was to explore the clinical effect and patients’ satisfaction of oxycontin combined with gabapentin in treatment of severe cancer pain. After titration of morphine, 60 severe cancer patients with visual analog score (VAS) more than 7 were randomly divided into trial group (n = 30) and control group (n = 30). The control group was administered oxycontin and placebo, and the trial group was given oxycontin and gabapentin. VAS score was recorded pre- and post-treatment; while daily dose of oxycontin, daily cost of pain relief and life quality score were observed 1 week, 1 month, 2 months, 3 months, and 6 months post-treatment. We found that daily dose of oxycontin 1 month post was comparable between the 2 groups (P > 0.05). Three months post, compared with control group (58.0 ± 15.2 mg), average daily dose of oxycontin was significant lower in trial group (33.4 ± 11 mg) (P < 0.001). Average daily cost of pain relief in trail group (34.5 ± 10.2 RMB) was less than the control group (52.4 ± 13.7 RMB) (P < 0.001). Life quality score increased in all of the patients in both group post-treatment (P < 0.05); while life quality score in trail group was greater than in control group 3 months (46.8 ± 4.5 vs 43.5 ± 4.6, P = 0.007) and 6 months (46.5 ± 4.8 vs 41.4 ± 4.3, P < 0.001) post-treatment. The incidence of drowsiness and dizziness was comparable between the 2 groups (P > 0.05), while the incidence of nausea and vomiting (P = 0.038), and constipation (P < 0.001) was higher in the control group.We concluded that oxycontin combined with gabapentin used in severe cancer pain management can control pain effectively, decreased the dose of oxycontin and the cost of cancer pain relief, and reduced the incidence of nausea and vomiting, and constipation, increased the life quality.

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Section: Discussionmentioning

confidence: 99%

The research on long-term clinical effects and patients’ satisfaction of gabapentin combined with oxycontin in treatment of severe cancer pain

Chen¹,

Wang

et al. 2016

Medicine

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“…243,244 Gabapentin may be used in combination with opioid or nonopioid analgesics for treatment of mucositis, although studies on the effectiveness of this approach have reported mixed results. 43,245 Oral care protocols, consisting of good oral hygiene and prophylactic mouth rinses may be used for prevention of mucositis. 246 Prophylactic mouth rinses (also called "magic mouthwash") compositions vary significantly, including ingredients such as antibiotics, antihistamines, antifungals, corticosteroids, and antacids.…”

Section: Management Of Bone Pain Without An Oncologic Emergencymentioning

confidence: 99%

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Swarm

Paice

Anghelescu

et al. 2019

Journal of the National Comprehensive Cancer Network

410

282

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In recent years, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Adult Cancer Pain have undergone substantial revisions focusing on the appropriate and safe prescription of opioid analgesics, optimization of nonopioid analgesics and adjuvant medications, and integration of nonpharmacologic methods of cancer pain management. This selection highlights some of these changes, covering topics on management of adult cancer pain including pharmacologic interventions, nonpharmacologic interventions, and treatment of specific cancer pain syndromes. The complete version of the NCCN Guidelines for Adult Cancer Pain addresses additional aspects of this topic, including pathophysiologic classification of cancer pain syndromes, comprehensive pain assessment, management of pain crisis, ongoing care for cancer pain, pain in cancer survivors, and specialty consultations.

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“…Although the results are mixed, the data support further investigation of gabapentin in this setting. [28][29][30][31] This is a prospective, randomized trial to assess the efficacy of prophylactic gabapentin in preventing local and systemic symptoms in patients with HNC undergoing chemoradiation. The primary aim was to determine whether the administration of prophylactic gabapentin would decrease the pain severity across the active treatment period compared with that of control.…”

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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Randomized trial of standard pain control with or without gabapentin for pain related to radiation-induced mucositis in head and neck cancer

Cited by 37 publications

References 30 publications

The research on long-term clinical effects and patients’ satisfaction of gabapentin combined with oxycontin in treatment of severe cancer pain

The research on long-term clinical effects and patients’ satisfaction of gabapentin combined with oxycontin in treatment of severe cancer pain

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

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

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