The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Persistent Post-radiotherapy Pain and Locoregional Recurrence in Head and Neck Cancer- Is There a Hidden Link?

  • Received : 2014.10.07
  • Accepted : 2015.01.12
  • Published : 2015.04.01
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Abstract

Background: To explore the relationship between persistent post-radiotherapy pain and locoregional recurrence in head and neck cancer patients. Methods: Five year retrospective data was reviewed of 86 patients of head and neck cancer treated with radiotherapy who continued to have pain at 6 weeks after completion of treatment. At follow-up after 3 months, these patients were stratified into: Group A (n = 39) constituted of patients whose pain subsided and Group B (n = 47) were patients who continued to have persistent pain. Results: At median follow-up time of 25 months (range: 8-47), one patient (2.6%) and 18 (38.3%) patients in group A and group B had locoregional recurrence respectively (P < 0.0001). Furthermore, group B patients had higher mean pain score levels as compared to group A (P = 0.03). Patients in whom pain subsided within 3 months had statistically much greater disease-free survival in comparison to those with persistent pain (P < 0.0001). Conclusions: Pain in head and neck cancer is an important symptom and should be considered a poor prognostic factor. In the current study, the majority of the patients with persistent pain had recurrent disease as compared to those in whom pain subsided within 3 months of post-treatment. It is suggested that patients with persistent pain need more intense follow-up and should be investigated thoroughly to detect recurrence at an early stage to provide a better quality of life.

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References

  1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127: 2893-917. https://doi.org/10.1002/ijc.25516
  2. Raj PP, Phero JC. Pain control in cancer of the head and neck. In: Comprehensive management of Head and Neck Tumors. 2nd ed. Edited by Thawley SE, Panje WR. Philadelphia, WB Saunders. 1987, pp 42-68.
  3. Foley KM. The treatment of cancer pain. N Engl J Med 1985; 313: 84-95. https://doi.org/10.1056/NEJM198507113130205
  4. Epstein JB, Wilkie DJ, Fischer DJ, Kim YO, Villines D. Neuropathic and nociceptive pain in head and neck cancer patients receiving radiation therapy. Head Neck Oncol 2009; 1: 26. https://doi.org/10.1186/1758-3284-1-26
  5. Smit M, Balm AJ, Hilgers FJ, Tan IB. Pain as sign of recurrent disease in head and neck squamous cell carcinoma. Head Neck 2001; 23: 372-5. https://doi.org/10.1002/hed.1046
  6. Scharpf J, Karnell LH, Christensen AJ, Funk GF. The role of pain in head and neck cancer recurrence and survivorship. Arch Otolaryngol Head Neck Surg 2009; 135: 789-94. https://doi.org/10.1001/archoto.2009.107
  7. Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, et al. AJCC Cancer Staging Manual. 6th ed. Philadelphia, USA, Lippincott-Raven. 2002, pp, 33-46.
  8. Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract 2003; 3: 310-6. https://doi.org/10.1111/j.1530-7085.2003.03034.x
  9. Ventafridda V, Saita L, Ripamonti C, De Conno F. WHO guidelines for the use of analgesics in cancer pain. Int J Tissue React 1985; 7: 93-6.
  10. Therasse P. Measuring the clinical response. What does it mean? Eur J Cancer 2002; 38: 1817-23. https://doi.org/10.1016/S0959-8049(02)00182-X
  11. Chen YH, Jian JJ, Chan KY, Tsai SY, Cheng SH, Yen KC, et al. Definitive chemoirradiation for resectable head and neck cancer: treatment outcome and prognostic significance of MRI findings. Br J Radiol 2008; 81: 490-8. https://doi.org/10.1259/bjr/23571630
  12. Grond S, Zech D, Lynch J, Diefenbach C, Schug SA, Lehmann KA. Validation of World Health Organization guidelines for pain relief in head and neck cancer. A prospective study. Ann Otol Rhinol Laryngol 1993; 102: 342-8. https://doi.org/10.1177/000348949310200504
  13. Cuffari L, Tesseroli de Siqueira JT, Nemr K, Rapaport A. Pain complaint as the first symptom of oral cancer: a descriptive study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 56-61. https://doi.org/10.1016/j.tripleo.2005.10.041

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