Efficacy of controlled-release oxycodone for reducing pain due to oral mucositis in nasopharyngeal carcinoma patients treated with concurrent chemo...

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Supportive Measures
Complications/Toxicities of Treatment
Radiation Oncology
Head and Neck Cancers
Presenter Xin Hua
Citation Annals of Oncology (2018) 29 (suppl_9): ix94-ix104. 10.1093/annonc/mdy438
Authors X. Hua1, L. Chen2, Q. Zhu3, W. Hu2, C. Lin2, Z. Long1, W. Wen1, X. Sun1, Z. Lu2, Q. Chen2, D. Luo2, R. Sun2, H. Mo2, L. Tang2, W. Zhang1, Z. He1, H. Mai2, H. Lin1, L. Guo4
  • 1Department Of Radiotherapy, SYSUCC, 510060 - Guangzhou/CN
  • 2Department Of Npc, SYSUCC, 510060 - Guangzhou/CN
  • 3State Key Laboratory Of Oncology In South China, SYSUCC, 510060 - Guangzhou/CN
  • 4Department Of Npc, Cancer Centre Sun Yat-Sen University, 510060 - Guangzhou/CN

Abstract

Background

Pain due to oral mucositis (OM) is a major problem during concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) patients.

Methods

We enrolled 56 NPC patients receiving CCRT and allocated them to two groups: moderate pain group (n = 27) and a severe pain group (n = 29) according to the degree of pain reported (moderate = numerical rating scale [NRS] score 4-6 or severe = NRS score 7-10) at initiation of controlled-release oxycodone (CRO) treatment.

Results

Total dose of CRO was significantly higher in severe pain patients than in moderate pain patients (791.60 ± 332.449 mg vs. 587.27 ± 194.940 mg; P = 0.015). Moderate pain patients had significantly better quality of life (P = 0.037), lower weight loss (P = 0.030) and more active CCRT response (90.9% vs. 64.0%; P = 0.041). Although 24-hour pain control rate was comparable in the two groups (85.2% vs. 86.2%; P = 0.508), the moderate pain group score eventually stabilized at ∼2 vs. 3 in the severe pain group (P < 0.001); the titration time to reach bearable pain (NRS ≤3) was also significantly shorter in moderate pain patients (2.45 ± 0.60 days vs. 3.60 ± 1.98 days; P = 0.012). Incidence of adverse events was comparable in both groups.

Conclusions

The study findings suggest that early introduction of low-dose CRO at the moderate pain stage could help reduce the total dose required, provide better pain control, improve quality of life, enhance CCRT response.

Editorial acknowledgement

Clinical trial identification

NCT03045484.

Legal entity responsible for the study

SYSUCC.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.