title: Temporal course and predictive factors of analgesic opioid requirement for chemoradiation-induced oral mucositis in oropharyngeal cancer.
abstract: Oral mucositis (OM)-related pain affects most patients with head and neck cancer during treatments, but its management is not standardized.
  
  
  
  We retrospectively collected data about the opioid therapy used for OM-induced pain in all patients with oropharyngeal cancer treated with chemoradiotherapy (CRT) between 2009 and 2013. To compare the different opioids, a conversion into oral morphine equivalent daily dose (OMEDD) was performed. The highest OMEDD (h-OMEDD) and the opioids' weekly increase were associated with patient, tumor, or treatment-related characteristics in order to identify predictive factors of opioid consumption.
  
  
  
  Ninety-seven percent of patients received opioids. The h-OMEDD was significantly correlated with a higher OM-grade and a lower smoking history. The weekly opioids' increase was higher in patients with lower smoking history and human papillomavirus (HPV) positivity.
  
  
  
  Opioid therapy remains the mainstay for OM-related pain management during CRT. The role of previous smoking and HPV on opioid use needs further confirmations. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1521-E1527, 2016.
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Salvatore
authors: S
authors: Alfieri
authors: Supportive Care Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Carla I
authors: CI
authors: Ripamonti
authors: Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Trieste, Italy.
authors: Sara
authors: S
authors: Marceglia
authors: Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Ester
authors: E
authors: Orlandi
authors: Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Nicola A
authors: NA
authors: Iacovelli
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Roberta
authors: R
authors: Granata
authors: Medical Physics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Anna
authors: A
authors: Cavallo
authors: Tobacco Control Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Paolo
authors: P
authors: Pozzi
authors: Tobacco Control Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Roberto
authors: R
authors: Boffi
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Cristiana
authors: C
authors: Bergamini
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Martina
authors: M
authors: Imbimbo
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Laura
authors: L
authors: Pala
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Carlo
authors: C
authors: Resteghini
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Aurora
authors: A
authors: Mirabile
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Laura D
authors: LD
authors: Locati
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Lisa
authors: L
authors: Licitra
authors: Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Paolo
authors: P
authors: Bossi
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000139:chemically induced*; D009959:Oropharyngeal Neoplasms / Q000628:therapy*; D012907:Smoking
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid
keywords: opioids; oral mucositis; oropharyngeal cancer; pain; smoking