title: Pharmacological and other interventions for head and neck cancer pain: a systematic review.
abstract: OBJECTIVE
  Pain is a common complication in head and neck cancer. The aim of this paper is to evaluate the evidence from randomised control trials investigating pharmacological and non-pharmacological methods of pain management in head and neck cancer.
  
  
  METHODS
  Medline, Embase and the Cochrane library databases were searched. Squamous cell carcinomas of the head and neck excluding nasopharyngeal and salivary gland cancers were included. The limits were "human" and "randomised clinical trials". A quality assessment was carried out.
  
  
  RESULTS
  13 studies were included with a total of 644 participants. The primary outcome for most of these papers was pain control post-treatment. Levels of bias varied between the studies. Majority (12 out of the 13 studies) reported intervention to be superior to the control or standard therapy in pain management. Only 46% of the studies were carried out on an intention to treat basis. Two studies reported high dropout rates, with one at 66%.
  
  
  CONCLUSIONS
  There is insufficient evidence from randomised clinical trials to suggest an optimal pharmacological intervention for head and neck cancer pain post-treatment. Further high quality randomised clinical trials should be conducted to develop an optimal management strategy for head and neck cancer pain.
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen Aberdeen United Kingdom.
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Trotter
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen Aberdeen United Kingdom.
authors.forename: Lindsey A
authors.initials: LA
authors.lastname: Norton
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen Aberdeen United Kingdom.
authors.forename: Ann S
authors.initials: AS
authors.lastname: Loo
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen Aberdeen United Kingdom.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Munn
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen Aberdeen United Kingdom. ; University of Bremen Bremen Germany.
authors.forename: Elena
authors.initials: E
authors.lastname: Voge
authors.affiliation: Department of Otolaryngology, Aberdeen Royal Infirmary Aberdeen United Kingdom.
authors.forename: Kim W
authors.initials: KW
authors.lastname: Ah-See
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen Aberdeen United Kingdom.
authors.forename: Tatiana V
authors.initials: TV
authors.lastname: Macfarlane
keywords: head and neck neoplasms; opioid analgesics; pain measurement; postoperative pain; systematic review.