Alfieri Salvatore, Ripamonti Carla I, Marceglia Sara, Orlandi Ester, Iacovelli Nicola A, Granata Roberta, Cavallo Anna, Pozzi Paolo, Boffi Roberto, Bergamini Cristiana, Imbimbo Martina, Pala Laura, Resteghini Carlo, Mirabile Aurora, Locati Laura D, Licitra Lisa, Bossi Paolo
Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Supportive Care Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Head Neck. 2016 Apr;38 Suppl 1:E1521-7. doi: 10.1002/hed.24272. Epub 2016 Feb 5.
Oral mucositis (OM)-related pain affects most patients with head and neck cancer during treatments, but its management is not standardized.
We retrospectively collected data about the opioid therapy used for OM-induced pain in all patients with oropharyngeal cancer treated with chemoradiotherapy (CRT) between 2009 and 2013. To compare the different opioids, a conversion into oral morphine equivalent daily dose (OMEDD) was performed. The highest OMEDD (h-OMEDD) and the opioids' weekly increase were associated with patient, tumor, or treatment-related characteristics in order to identify predictive factors of opioid consumption.
Ninety-seven percent of patients received opioids. The h-OMEDD was significantly correlated with a higher OM-grade and a lower smoking history. The weekly opioids' increase was higher in patients with lower smoking history and human papillomavirus (HPV) positivity.
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.
口腔黏膜炎（OM）相关疼痛在头颈部癌患者的治疗过程中影响着大多数患者，但其管理并不规范。
我们回顾性收集了2009年至2013年间所有接受放化疗（CRT）的口咽癌患者中用于OM引起疼痛的阿片类药物治疗的数据。为比较不同的阿片类药物，进行了换算成口服吗啡等效日剂量（OMEDD）的操作。将最高OMEDD（h - OMEDD）和阿片类药物的每周增加量与患者、肿瘤或治疗相关特征相关联，以确定阿片类药物消耗的预测因素。
97%的患者接受了阿片类药物治疗。h - OMEDD与较高的OM分级和较低的吸烟史显著相关。吸烟史较低和人乳头瘤病毒（HPV）阳性的患者阿片类药物每周增加量更高。
阿片类药物治疗仍然是CRT期间OM相关疼痛管理的主要手段。既往吸烟和HPV在阿片类药物使用方面的作用需要进一步证实。© 2016威利期刊公司。《头颈》38: E1521 - E1527, 2016。
