Use of analgesics in patients affected by head & neck malignancy during palliative radiotherapy
Journal
Annals of Oncology Abstract book
Date Issued
2003
Author(s)
Kraleva, Slavica
Stojmenova, Vita
Abstract
Background: Treating the Head & Neck malignancy failure after surgery
and radiotherapy (RT) is still a problem. The roles of reirradiation and
chemotherapy are palliative. These patients (pts) suffered from moderate to
sever pain that was less responsive to opioid therapy. The aim of this study
was to evaluate efficiency among tramadol and amitriptyline in head & neck
cancer pts with moderate pain during palliative RT. Material and Methods:
30 pts (21 M, 9 F) affected by head & neck metastatic disease in lymph
nodes, failure after primary therapy. All pts included presented moderate
pain defined as VAS between 5–7, and were under NSAIDs treatment and
palliative RT. 15 pts (group A) used tramadol with initial dose 200 mg/day,
with doses escalated up to 300-400/day. Other 15 pts (group B) used
amitriptyline with starting dose 10 mg in the elderly and 25 mg in younger
pts with doses increased every few days, when doses have reached the
effective range (e.g. 75–100 mg). Pain was measured according the linear
VAS (0-10) at the start of and during the period and at the end of RT,
including day 0, 7, 14 and 21. Results: There was a difference between
groups in VAS evaluation, this was: 6.2, 5.3, 4.8, 4.9 at days 0, 7, 14, and 21
respectively for tramadol group-A and 6.1, 3.5, 1.7, 1.2, respectively for
group-B. Percentage of pts under pain control (VAS <3) was registered only
in group B in follow up visits (40.6% at day 7, 80% at day 14 and 86.6 % at
day 21). Conclusions: Tricyclic antidepressant-amitripyline was significant
efficiency pain treatment in head & neck cancer pts with moderated pain.
Considering our results, we supposed that there is distinct mechanism that
created neuropathic pain in the head & neck region.
available by spring 2003.
74P
and radiotherapy (RT) is still a problem. The roles of reirradiation and
chemotherapy are palliative. These patients (pts) suffered from moderate to
sever pain that was less responsive to opioid therapy. The aim of this study
was to evaluate efficiency among tramadol and amitriptyline in head & neck
cancer pts with moderate pain during palliative RT. Material and Methods:
30 pts (21 M, 9 F) affected by head & neck metastatic disease in lymph
nodes, failure after primary therapy. All pts included presented moderate
pain defined as VAS between 5–7, and were under NSAIDs treatment and
palliative RT. 15 pts (group A) used tramadol with initial dose 200 mg/day,
with doses escalated up to 300-400/day. Other 15 pts (group B) used
amitriptyline with starting dose 10 mg in the elderly and 25 mg in younger
pts with doses increased every few days, when doses have reached the
effective range (e.g. 75–100 mg). Pain was measured according the linear
VAS (0-10) at the start of and during the period and at the end of RT,
including day 0, 7, 14 and 21. Results: There was a difference between
groups in VAS evaluation, this was: 6.2, 5.3, 4.8, 4.9 at days 0, 7, 14, and 21
respectively for tramadol group-A and 6.1, 3.5, 1.7, 1.2, respectively for
group-B. Percentage of pts under pain control (VAS <3) was registered only
in group B in follow up visits (40.6% at day 7, 80% at day 14 and 86.6 % at
day 21). Conclusions: Tricyclic antidepressant-amitripyline was significant
efficiency pain treatment in head & neck cancer pts with moderated pain.
Considering our results, we supposed that there is distinct mechanism that
created neuropathic pain in the head & neck region.
available by spring 2003.
74P
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