化学放射線療法を行う頭頸部がん患者を対象とするクリニカルパスを用いた疼痛管理法有効性／安全性評価試験

加藤 健吾; 松浦 一登; 全田 貞幹; 立花 弘之; 本間 明宏; 桐田 忠昭; 門田 伸也; 大田 洋二郎; 岩江 信法; 大鶴 洋; 秋元 哲夫; 田原 信; 浅井 昌大

doi:10.5981/jjhnc.37.153

An opioid-based pain control program for head and neck cancer patients undergoing chemoradiation therapy achieves a high completion rate of radiation

Kengo Kato, Kazuto Matsuura, Sadamoto Zenda, Hiroyuki Tachibana, Akihiro Homma, Tadaaki Kirita, Nobuya Monden, Yojiro Ota, Shigemichi Iwae, Hiroshi Otsuru, Tetsuo Akimoto, Makoto Tahara, Masao Asai

Author information

Kengo Kato
Division of Head and Neck Surgery, Miyagi Cancer Center
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine
Kazuto Matsuura
Division of Head and Neck Surgery, Miyagi Cancer Center
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine
Sadamoto Zenda
Division of Radiation Oncology, National Cancer Center Hospital East
Hiroyuki Tachibana
Division of Radiation Oncology, Aichi Cancer Center Hospital
Akihiro Homma
Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine
Tadaaki Kirita
Department of Oral and Maxillofacial Surgery, Nara Medical University
Nobuya Monden
Division of Head and Neck Oncology, Shikoku Cancer Center
Yojiro Ota
Division of Oral and Surgery, Shizuoka Cancer Center
Shigemichi Iwae
Department of Head and Neck Surgery, Hyogo Cancer Center
Hiroshi Otsuru
Department of Dentistry Oral Surgery, National Hospital Organization Tokyo Medical Center
Tetsuo Akimoto
Department of Radiation Oncology, Tokyo Women's Medical University
Makoto Tahara
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East
Masao Asai
Division of Head and Neck Surgery, National Cancer Center Hospital

Keywords: Chemoradiation therapy, Supportive care, Pain management, Head and neck cancer, PEG

JOURNAL FREE ACCESS

2011 Volume 37 Issue 1 Pages 153-157

DOI https://doi.org/10.5981/jjhnc.37.153

Details

Abstract

Background: Appropriate supportive care is essential for intensive chemoradiation therapy (CRT), and pain management is an important supportive care for CRT for head and neck cancer. We developed an opioid-based pain control program for head and neck cancer patients undergoing CRT, and assessed its efficacy and safety.
Objective and Method: 110 head and neck cancer patients undergoing platinum-based concomitant CRT were enrolled from 10 cancer centers or university hospitals. Their pain caused by CRT was managed with a four-step opioid-based pain control program, and adverse events and usage of opioid were analyzed.
Results: 101 suitable cases of 110 patients were analyzed. 53% of cases suffered grade 3-4 mucositis. The rate of completion of radiotherapy was 99% and the rate of unplanned breaks in radiotherapy was 13%. The usage rate of opioid was 83% and the rate of compliance with the pain control program was 92%. The median maximum quantity of morphine used per day was 35 mg. No patient had to stop the opioid program or radiotherapy due to adverse effects of opioids.
Conclusion: An opioid-based pain control program for head and neck cancer patients undergoing CRT achieves a high completion rate of radiation.

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