title: Transdermal fentanyl for pain caused by radiotherapy in head and neck cancer patients treated in an outpatient setting: a multicenter trial in Taiwan.
abstract: OBJECTIVE
  This study evaluated the efficacy and safety of transdermal fentanyl in the outpatient treatment of head and neck cancer patients with pain caused by radiotherapy.
  
  
  METHODS
  Patients with a visual analogue scale score >or=4 were invited to participate in the study. The following variables were collected: visual analogue scale, the Brief Pain Inventory, concomitant pain medications and adverse effects. A total of 163 head and neck cancer patients were enrolled (148 males and 15 females; median age, 53 years; age range, 21-72 years). Seventy-two (44%) patients had a visual analogue scale score >6 at enrollment, despite the use of non-steroidal anti-inflammatory drugs or weak opioids. Ninety-four (57.7%) patients received concurrent chemotherapy.
  
  
  RESULTS
  A total of 88 patients completed the study, whereas 55 underwent a drop-out by side effects. The most frequently reported adverse events were vomiting (23.9%) and nausea (16.6%). Treatment with transdermal fentanyl resulted in a significant decrease in visual analogue scale and Brief Pain Inventory scores that persisted during treatment. In the overall efficacy evaluation, the pain-alleviating effect, the easiness of application and the overall impression of transdermal fentanyl were rated as good by 54.5%, 65.9% and 59.1% of the completers, respectively. Effects of transdermal fentanyl were rated as good by 64.8% of the investigators.
  
  
  CONCLUSIONS
  Our data provide evidence that transdermal fentanyl is effective and relatively easy to use for outpatient treatment of pain control in head and neck cancer patients following radiotherapy in selected patients. Reduction of side effects and effective pain management need to be paramount in the management of head and neck cancer patients undergoing radiotherapy.
authors.affiliation: Department of Medicine, Chang Gung Memorial Hospital-Linkou Medical Center, Linkou, Taiwan.
authors.forename: Joseph Tung-Chieh
authors.initials: JT
authors.lastname: Chang
authors.forename: Chien Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Jin-Ching
authors.initials: JC
authors.lastname: Lin
authors.forename: Moon-Sing
authors.initials: MS
authors.lastname: Lee
authors.forename: Yu-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D011878:Radiotherapy / Q000009:adverse effects*; D013624:Taiwan; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl