Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Support Care Cancer. 2023 Mar 17;31(4):221. doi: 10.1007/s00520-023-07683-w.
This review was designed to compile the currently available evidence on the prophylactic use of gabapentin in the head and neck cancer patient population.
A systematic search was conducted of PubMed, Web of Science, and Google Scholar to identify articles related to the use of prophylactic gabapentin in patients undergoing head and neck cancer therapy. Candidate studies were screened for inclusion and a subsequent bias assessment was conducted by multiple reviewers. Meta-analysis was conducted in cases in which the studies used compatible outcome measures.
Ten studies were identified that met the inclusion criteria and were assessed for bias. Among the four small studies that examined pain prevention, 2 were positive and 2 were inconclusive. Three of the four studies examiniRDng opioid use noted less need for opioids in the treatment arm. Meta-analysis of the pertinent studies showed no difference in feeding tube placement (RD = 0.64%, 95%CI: (- 25.8%, 27.1%), p = 0.962) but substantially less weight loss among those in the treatment arm (p = 0.047).
Prophylactic gabapentin appears to be a promising treatment option for preventing pain, reducing opioids, and reducing weight loss in patients undergoing head and neck cancer therapy. However, the studies on the treatment to date are small and several have a substantial risk of bias.
本综述旨在汇集目前关于预防性使用加巴喷丁在头颈部癌症患者人群中的证据。
系统检索 PubMed、Web of Science 和 Google Scholar，以确定与预防性使用加巴喷丁治疗头颈部癌症患者相关的文章。对候选研究进行筛选以纳入，并由多名评审员进行后续偏倚评估。如果研究使用了兼容的结果测量，则进行荟萃分析。
确定了 10 项符合纳入标准的研究，并对其偏倚进行了评估。在四项研究中，有两项研究检查了疼痛预防，这两项研究是阳性的，另外两项研究则没有定论。四项研究中有三项研究检查了阿片类药物的使用，结果表明治疗组需要的阿片类药物较少。相关研究的荟萃分析显示，在放置饲管方面没有差异（RD = 0.64%，95%CI：（-25.8%，27.1%），p = 0.962），但治疗组的体重减轻明显减少（p = 0.047）。
预防性使用加巴喷丁似乎是一种有前途的治疗选择，可以预防疼痛、减少阿片类药物的使用并减轻头颈部癌症治疗患者的体重减轻。然而，迄今为止的研究规模较小，其中几项研究存在较大的偏倚风险。
