BACKGROUND: This retrospective study evaluated the efficacy of gabapentin for the treatment of pain syndromes related to radiation-induced mucositis in patients with head and neck cancers treated with concurrent chemoradiation. METHODS: Data from 42 patients with head and neck malignancies treated with concurrent chemoradiotherapy using an intensity-modulated radiotherapy technique were analyzed. Gabapentin was initiated in the second week of radiotherapy. Opiates were prescribed in addition to gabapentin as clinically indicated to obtain adequate pain control. RESULTS: At a median dose of 2700 mg/day of gabapentin, only 33% and 55% of patients required additional low-dose narcotic medications for pain control during the third and fourth week of treatment, respectively, despite exhibiting a grade 2 or higher mucositis in 71% and 86% of the patients, respectively. Furthermore, during the last weeks of treatment, 71% of the patients required additional low-dose opiates for adequate pain control, despite the presence of grade 2 or higher mucositis in 95% and 100% of patients at Weeks 5 and 6, respectively. Only 1 patient had a treatment-related interruption of >3 days during chemoradiotherapy. CONCLUSIONS: Gabapentin appears to be promising in reducing the need for high total doses of opioids and avoiding unplanned treatment interruptions for patients with head and neck malignancies treated with concurrent chemoradiotherapy and should be further evaluated prospectively in controlled clinical trials.
BACKGROUND: This retrospective study evaluated the efficacy of gabapentin for the treatment of pain syndromes related to radiation-induced mucositis in patients with head and neck cancers treated with concurrent chemoradiation. METHODS: Data from 42 patients with head and neck malignancies treated with concurrent chemoradiotherapy using an intensity-modulated radiotherapy technique were analyzed. Gabapentin was initiated in the second week of radiotherapy. Opiates were prescribed in addition to gabapentin as clinically indicated to obtain adequate pain control. RESULTS: At a median dose of 2700 mg/day of gabapentin, only 33% and 55% of patients required additional low-dose narcotic medications for pain control during the third and fourth week of treatment, respectively, despite exhibiting a grade 2 or higher mucositis in 71% and 86% of the patients, respectively. Furthermore, during the last weeks of treatment, 71% of the patients required additional low-dose opiates for adequate pain control, despite the presence of grade 2 or higher mucositis in 95% and 100% of patients at Weeks 5 and 6, respectively. Only 1 patient had a treatment-related interruption of >3 days during chemoradiotherapy. CONCLUSIONS:Gabapentin appears to be promising in reducing the need for high total doses of opioids and avoiding unplanned treatment interruptions for patients with head and neck malignancies treated with concurrent chemoradiotherapy and should be further evaluated prospectively in controlled clinical trials.
Authors: Wuyang Yang; Todd R McNutt; Sara A Dudley; Rachit Kumar; Heather M Starmer; Christine G Gourin; Joseph A Moore; Kimberly Evans; Mysha Allen; Nishant Agrawal; Jeremy D Richmon; Christine H Chung; Harry Quon Journal: Dysphagia Date: 2016-01-11 Impact factor: 3.438
Authors: Deborah P Saunders; Joel B Epstein; Sharon Elad; Justin Allemano; Paolo Bossi; Marianne D van de Wetering; Nikhil G Rao; Carin Potting; Karis K Cheng; Annette Freidank; Michael T Brennan; Joanne Bowen; Kristopher Dennis; Rajesh V Lalla Journal: Support Care Cancer Date: 2013-07-06 Impact factor: 3.603
Authors: Shivani Shinde; Pamela Gordon; Prashant Sharma; James Gross; Mellar P Davis Journal: Support Care Cancer Date: 2014-08-29 Impact factor: 3.603
Authors: Robert A Swarm; Amy Pickar Abernethy; Doralina L Anghelescu; Costantino Benedetti; Sorin Buga; Charles Cleeland; Oscar A Deleon-Casasola; June G Eilers; Betty Ferrell; Mark Green; Nora A Janjan; Mihir M Kamdar; Michael H Levy; Maureen Lynch; Rachel M McDowell; Natalie Moryl; Suzanne A Nesbit; Judith A Paice; Michael W Rabow; Karen L Syrjala; Susan G Urba; Sharon M Weinstein; Mary Dwyer; Rashmi Kumar Journal: J Natl Compr Canc Netw Date: 2013-08 Impact factor: 11.908