Qiu Michelle L, Iovoli Austin J, Khan Michael, Farrugia Mark K, Ma Sung Jun, Singh Anurag K
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 955 Main Street, Buffalo, NY 14203, USA.
Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14203, USA.
Cancers (Basel). 2023 Mar 28;15(7):2003. doi: 10.3390/cancers15072003.
The role of prophylactic high-dose gabapentin for the management of oral mucositis during radiation therapy for head and neck squamous cell carcinoma (HNSCC) remains controversial.
A retrospective cohort analysis was performed on primary HNSCC patients treated at our institution. Kruskal-Wallis and Fisher's exact tests were used to compare the patients' baseline characteristics. Multivariate competing risk and logistic regressions were performed to evaluate time to first opioid use and feeding tube placement.
In total, 480 consecutive HNSCC patients were included. Within this cohort, 186 patients received 3600 mg gabapentin, 182 received 300 to 3200 mg gabapentin, and 112 received no gabapentin. The time to first opioid use was greater in the 3600 mg group compared with the no gabapentin group (34.3 vs. 23.9 days, < 0.001) and to the 300 to 3200 mg group (28.0 days, < 0.001). The proportion of patients requiring opioids at any point during RT was lower in the 3600 mg gabapentin group compared with the no gabapentin group (31.8% vs. 60.1%, < 0.001) and with the 300 to 3200 mg group (63.8%, < 0.001).
Prophylactic use of 3600 mg gabapentin was well tolerated, halved overall opioid use, and delayed the time to first opioid use during radiation therapy.
预防性大剂量加巴喷丁对头颈部鳞状细胞癌（HNSCC）放射治疗期间口腔黏膜炎的管理作用仍存在争议。
对在本机构接受治疗的原发性HNSCC患者进行回顾性队列分析。采用Kruskal-Wallis检验和Fisher精确检验比较患者的基线特征。进行多变量竞争风险和逻辑回归分析，以评估首次使用阿片类药物和放置饲管的时间。
总共纳入了480例连续的HNSCC患者。在该队列中，186例患者接受3600mg加巴喷丁，182例接受300至3200mg加巴喷丁，112例未接受加巴喷丁。与未接受加巴喷丁组相比，3600mg组首次使用阿片类药物的时间更长（34.3天对23.9天，<0.001），与300至3200mg组相比也更长（28.0天，<0.001）。与未接受加巴喷丁组相比，3600mg加巴喷丁组在放疗期间任何时间需要使用阿片类药物的患者比例更低（31.8%对60.1%，<0.001），与300至3200mg组相比也更低（63.8%，<0.001）。
预防性使用3600mg加巴喷丁耐受性良好，使总体阿片类药物使用量减半，并延迟了放疗期间首次使用阿片类药物的时间。
