Temporal course and predictive factors of analgesic opioid requirement for chemoradiation‐induced oral mucositis in oropharyngeal cancer

Alfieri, Salvatore; Ripamonti, Carla; Marceglia, Sara; Orlandi, Ester; Iacovelli, Nicola Alessandro; Granata, Roberta; Cavallo, A.; Pozzi, Paolo; Boffi, Roberto; Bergamini, Cristiana; Imbimbo, Martina; Pala, Laura; Resteghini, Carlo; Mirabile, Aurora; Locati, Laura D.; Licitra, Lisa; Bossi, Paolo

doi:10.1002/hed.24272

Cited by 27 publications

(28 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is interesting to note the double pattern of toxicities in HPV-related diseases: in the acute phase, incidence of mucositis, dysphagia, and opioids use are higher in HPV-positive cancers than in their negative counterpart [33,34]; in the late period, however, the rate of toxicities changes in these 2 groups as showed by our results. HPV-positive microenvironment (richer in effector T cells, cytokines and chemokines) may explain the higher level of acute inflammation [35].…”

Section: Discussionsupporting

confidence: 53%

Predictors of Patient-Reported Dysphagia Following IMRT Plus Chemotherapy in Oropharyngeal Cancer

et al. 2018

Self Cite

View full text Add to dashboard Cite

The aim of this cross-sectional study is to evaluate the factors associated with patient-reported dysphagia in patients affected by locally advanced oropharyngeal cancer (OPC) treated with definitive intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy (CHT), with or without induction CHT. We evaluated 148 OPC patients treated with IMRT and concurrent CHT, without evidence of disease and who had completed their treatment since at least 6 months. At their planned follow-up visit, patients underwent clinical evaluation and completed the M.D. Anderson dysphagia inventory (MDADI) questionnaire. The association between questionnaire composite score (MDADI-CS) and different patients' and tumor's characteristics and treatments (covariates) was investigated by univariable and multivariable analyses, the latter including only covariates significant at univariable analysis. With a median time from treatment end of 30 months [range 6-74 months, interquartile range (IQR) 16-50 months], the median (IQR) MDADI-CS was 72 (63-84). The majority of patients (82.4%) had a MDADI-CS ≥ 60. At multivariable analysis, female gender, human papilloma virus (HPV)-negative status, and moderate and severe clinician-rated xerostomia were significantly associated with lower MDADI-CS. Patient-perceived dysphagia was satisfactory or acceptable in the majority of patients. HPV status and xerostomia were confirmed as important predictive factors for swallowing dysfunction after radiochemotherapy. Data regarding female gender are new and deserve further investigation.

show abstract

Section: Discussionsupporting

confidence: 53%

Predictors of Patient-Reported Dysphagia Following IMRT Plus Chemotherapy in Oropharyngeal Cancer

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…A retrospective study showed that opioid therapy remains a corner stone for OM pain management in CCRT, as suggested by the MASCC/ISOO guidelines (33, 198). …”

Section: Symptomatic Treatment Of Riommentioning

confidence: 99%

Radiation-Induced Oral Mucositis

2017

View full text Add to dashboard Cite

Radiation-induced oral mucositis (RIOM) is a major dose-limiting toxicity in head and neck cancer patients. It is a normal tissue injury caused by radiation/radiotherapy (RT), which has marked adverse effects on patient quality of life and cancer therapy continuity. It is a challenge for radiation oncologists since it leads to cancer therapy interruption, poor local tumor control, and changes in dose fractionation. RIOM occurs in 100% of altered fractionation radiotherapy head and neck cancer patients. In the United Sates, its economic cost was estimated to reach 17,000.00 USD per patient with head and neck cancers. This review will discuss RIOM definition, epidemiology, impact and side effects, pathogenesis, scoring scales, diagnosis, differential diagnosis, prevention, and treatment.

show abstract

“…Eighty to 100% of adult patients who undergo radiotherapy with or without concurrent chemotherapy for head and neck cancer will experience oral mucositis as a painful side effect of their cancer treatment. 1 , 4 , 9 , 16 Oral mucositis is painful damage to the mucosa in the oral cavity and the pharynx and is associated with vital oral dysfunction such as swallowing problems. 3 It has been identified by patients as the most severe side effect associated with cancer treatment in head and neck cancer patients as it induces severe problems with eating, drinking, and speaking.…”

Section: Introductionmentioning

confidence: 99%

“… 3 It has been identified by patients as the most severe side effect associated with cancer treatment in head and neck cancer patients as it induces severe problems with eating, drinking, and speaking. 1 , 3 …”

Section: Introductionmentioning

confidence: 99%

“… 16 Paracetamol, opioids, and gamma-aminobutyric acid analogs are currently the most frequently used systemic analgesic treatments, but a few data on the most beneficial analgesic therapy are available. 1 At present, no effective pain treatment without substantial side effects exists for patients with severe oral mucositis pain, and in many patients treated with high-dose opioids there is a lack of sufficient pain relief. 8 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of bupivacaine lozenges on oral mucositis pain: a randomized controlled multicenter phase II study

Mogensen

Treldal

Kristensen

et al. 2017

PR9

View full text Add to dashboard Cite

show abstract

Temporal course and predictive factors of analgesic opioid requirement for chemoradiation‐induced oral mucositis in oropharyngeal cancer

Abstract: Opioid therapy remains the mainstay for OM-related pain management during CRT. The role of previous smoking and HPV on opioid use needs further confirmations. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1521-E1527, 2016.

Cited by 27 publications

References 26 publications

Predictors of Patient-Reported Dysphagia Following IMRT Plus Chemotherapy in Oropharyngeal Cancer

Predictors of Patient-Reported Dysphagia Following IMRT Plus Chemotherapy in Oropharyngeal Cancer

Radiation-Induced Oral Mucositis

Effect of bupivacaine lozenges on oral mucositis pain: a randomized controlled multicenter phase II study

Contact Info

Product

Resources

About