Transdermal fentanyl for pain due to chemoradiotherapy-induced oral mucositis in nasopharyngeal cancer patients: evaluating efficacy, safety, and improvement in quality of life

Guo, Shu; Wu, San‐Gang; Zhou, Juan; Feng, Hui-Xia; Li, Fengyan; Wu, Yingjia; Sun, Jiayuan; He, Zhenyu

doi:10.2147/dddt.s60187

Cited by 14 publications

(3 citation statements)

References 31 publications

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“…Fentanyl may be effective to treat pain due to OM in patients treated with CT, with or without RT [50]. A single-center study showed that transdermal fentanyl reduces the mean pain scores when administered at 25 μg/h during CT-RT [137].…”

Section: A Comprehensive Managementmentioning

confidence: 99%

Mucosal Injury during Anti-Cancer Treatment: From Pathobiology to Bedside

Basile

Nardo

Corvaja

et al. 2019

Cancers

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Mucositis is one of the most common debilitating side effects related to chemotherapy (CT), radiation therapy (RT), targeted agents and immunotherapy. It is a complex process potentially involving any portion of the gastrointestinal tract and injuring the mucosa, leading to inflammatory or ulcerative lesions. Mechanisms and clinical presentation can differ according both to the anatomic site involved (oral or gastrointestinal) and the treatment received. Understanding the pathophysiology and management of mucosal injury as a secondary effect of anti-cancer treatment is an important area of clinical research. Prophylaxis, early diagnosis, and adequate management of complications are essential to increase therapeutic success and, thus, improve the survival outcomes of cancer patients. This review focuses on the pathobiology and management guidelines for mucositis, a secondary effect of old and new anti-cancer treatments, highlighting recent advances in prevention and discussing future research options.

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Section: A Comprehensive Managementmentioning

confidence: 99%

Mucosal Injury during Anti-Cancer Treatment: From Pathobiology to Bedside

Basile

Nardo

Corvaja

et al. 2019

Cancers

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“…In patients with severe mucositis caused by aggressive cytotoxic anticancer agents administered during the conditioning regimen, fentanyl patch is a more convenient method of pain management than morphine injection and is a better option than sustained-release oral medication because of the severe oral pain experienced by these patients. Recent studies have indicated that fentanyl patch is an effective tool for the management of pain associated with oral mucositis caused by chemotherapy and is also a noninvasive application compared to injections, especially in immunosuppressed patients [ 26 , 27 ]. However, the lowest-dose fentanyl patch that can be used is 12 µg/h, which is equivalent to 10 mg morphine injection.…”

Section: Discussionmentioning

confidence: 99%

Drug use evaluation of opioid analgesics in pain management among patients with hematopoietic stem cell transplantation

Hong

Jeong

et al. 2020

Blood Res

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Background Hematopoietic stem cell transplantation (HSCT) patients usually experience mucositis, musculoskeletal pain associated with high-dose chemotherapy, radiation, post-HSCT infection, or graft-versus-host disease. Pain management is important for the patients' quality of life. We evaluated appropriate opioid analgesic use in HSCT patients to propose effective pain management strategies. Methods A retrospective analysis was conducted using electronic medical records of adult patients with HSCT treated with opioids for moderate to severe pain at Seoul National University Bundang Hospital. The numeric rating scale (NRS) was used in pain management. NRS scores of 4-10 correspond to moderate to severe pain. Appropriate opioid analgesic use was evaluated following published cancer pain management guidelines. Results In total, 119 cases were evaluated, including 369 episodes of moderate to severe pain. Mucositis-related, musculoskeletal, and headache pain occurred in 62.6%, 25.8%, and 6.0% of episodes, respectively. Frequently used opioids were intravenous tramadol (84.9%), fentanyl patch (73.9%), and intravenous morphine sulfate (68.9%). Intravenous and topical administrations were used for mucosal pain. In total, 95.0% of patients received appropriate short-acting opioids for initial pain management, 80.5% received appropriate doses of short-acting opioids, appropriate opioids dose adjustment was done after first assessment in 95.5% of patients, and 85.6% were converted to appropriate long-acting opioids. Conclusion Short-acting opioid analgesic use for initial pain management and dose adjustment after assessment were appropriate. However, initial and conversion dosages recommended by guidelines may be difficult to implement considering the severity of HSCT patients. Pain management guidelines specific for HSCT patients should be developed in the future.

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“…An early study examining the time trends and characteristics of prescribing opioids for patients with a variety of cancers, showed that fentanyl was prescribed 10.2% of the time during the last 3 months, particularly in head and neck cancer cases using transdermal patches on most occasions. The efficacy, safety, and quality of life of head and neck cancer patients using fentanyl transdermal patches were also evaluated in a variety of prospective studies to show a significant decrease in pain, a better quality of life, and reduced side effects, the most common being nausea and vomiting [ 80 , 81 , 82 ]. However, there is a lack of studies that compare Fentanyl transdermal patches with other opioid analgesics [ 79 ].…”

Section: Transdermal Drug Deliverymentioning

confidence: 99%

Localized Drug Delivery Systems: An Update on Treatment Options for Head and Neck Squamous Cell Carcinomas

Hariharan

Tran

2023

Pharmaceutics

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Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers in the world, with surgery, radiotherapy, chemotherapy, and immunotherapy being the primary treatment modalities. The treatment for HNSCC has evolved over time, due to which the prognosis has improved drastically. Despite the varied treatment options, major challenges persist. HNSCC chemotherapeutic and immunotherapeutic drugs are usually administered systemically, which could affect the patient’s quality of life due to the associated side effects. Moreover, the systemic administration of salivary stimulating agents for the treatment of radiation-induced xerostomia is associated with toxicities. Localized drug delivery systems (LDDS) are gaining importance, as they have the potential to provide non-invasive, patient-friendly alternatives to cancer therapy with reduced dose-limiting toxicities. LDDSs involve directly delivering a drug to the tissue or organ affected by the disease. Some of the common localized routes of administration include the transdermal and transmucosal drug delivery system (DDSs). This review will attempt to explore the different treatment options using LDDSs for the treatment of HNSCC and radiotherapy-induced damage and their potential to provide a better experience for patients, as well as the obstacles that need to be addressed to render them successful.

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Transdermal fentanyl for pain due to chemoradiotherapy-induced oral mucositis in nasopharyngeal cancer patients: evaluating efficacy, safety, and improvement in quality of life

Cited by 14 publications

References 31 publications

Mucosal Injury during Anti-Cancer Treatment: From Pathobiology to Bedside

Mucosal Injury during Anti-Cancer Treatment: From Pathobiology to Bedside

Drug use evaluation of opioid analgesics in pain management among patients with hematopoietic stem cell transplantation

Localized Drug Delivery Systems: An Update on Treatment Options for Head and Neck Squamous Cell Carcinomas

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