title: Persistent Post-radiotherapy Pain and Locoregional Recurrence in Head and Neck Cancer-Is There a Hidden Link?
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.
authors: Department of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors: Preety
authors: P
authors: Srivastava
authors: Department of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors: Pamela Alice
authors: PA
authors: Kingsley
authors: Department of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors: Himanshu
authors: H
authors: Srivastava
authors: Department of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors: Jaineet
authors: J
authors: Sachdeva
authors: Department of Community Medicine, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors: Paramdeep
authors: P
authors: Kaur
keywords: Disease-free survival; Follow-up studies; Head and neck neoplasms; Local recurrence; Pain; Quality of life