title: Advantage of early induction of opioid to control pain induced by irradiation in head and neck cancer patients.
abstract: OBJECTIVE
  Although radiotherapy is effective for head and neck cancer patients, the local pain evoked by the irradiation itself reduces food intake and frequently halts the treatment. Thus, pain control is an important problem in radiotherapy for head and neck cancer. We performed to examine whether early induction of low-dose, opioid from mild pain improves dietary and caloric intake, while reducing weight loss.
  
  
  METHODS
  The subjects were 43 patients who were hospitalized for head and neck cancer from 2004 to 2008. They were patients who underwent radiation treatment but those who did not undergo preoperative treatment. They were divided into two groups, depending on whether the pain was mild or moderate when an opioid was introduced (MILD and MODERATE, N=23 and 20, respectively).
  
  
  RESULTS
  The visual analog scale scores for pain were significantly lower in the MILD than in the MODERATE group at between 25 and 50 Gy. The amount of oxycodone used for pain was significantly lower in the MILD than the MODERATE group. A regular diet was maintained for significantly longer in the MILD group. Caloric intake was significantly higher in the MILD group at over 20 Gy. Weight loss was significantly lower in the MILD group at over 20 Gy. The incidence of side effects was equal in both groups.
  
  
  CONCLUSIONS
  Our results indicated that the introduction of opioids for mild pain during radiotherapy controls the level of pain, improving food intake in head and neck cancer patients.
authors.affiliation: Department of Pharmacy, Fukuoka University Hospital, Japan. htakase@fukuoka-u.ac.jp
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Takase
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Sakata
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yamano
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sueta
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nomoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004435:Eating / Q000187:drug effects; D002149:Energy Intake / Q000187:drug effects; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010098:Oxycodone / Q000008:administration & dosage / Q000009:adverse effects; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D011878:Radiotherapy / Q000009:adverse effects; D012720:Severity of Illness Index; D015431:Weight Loss / Q000187:drug effects
chemical_list: D000701:Analgesics, Opioid; D010098:Oxycodone