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Gabapentin for the treatment of pain syndrome related to radiation-induced mucositis in patients with head and neck cancer treated with concurrent chemoradiotherapy†
Version of Record online: 19 AUG 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 17, pages 4206–4213, 1 September 2010
How to Cite
Bar Ad, V., Weinstein, G., Dutta, P. R., Dosoretz, A., Chalian, A., Both, S. and Quon, H. (2010), Gabapentin for the treatment of pain syndrome related to radiation-induced mucositis in patients with head and neck cancer treated with concurrent chemoradiotherapy. Cancer, 116: 4206–4213. doi: 10.1002/cncr.25274
Presented in part at the American Society of Therapeutic Radiation Oncology Annual Meeting, Los Angeles, California, October 28-November 1, 2007.
- Issue online: 23 AUG 2010
- Version of Record online: 19 AUG 2010
- Manuscript Accepted: 15 JAN 2010
- Manuscript Revised: 7 DEC 2009
- Manuscript Received: 10 SEP 2009
- radiation-induced mucositis;
- head and neck malignancies;
- pain control
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.
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.
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.
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. Cancer 2010. © 2010 American Cancer Society.