Implications of Treatment Modality on Chronic Opioid Use Following Treatment for Head and Neck Cancer.

Autor: Bollig CA; Department of Otolaryngology-Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA., Kinealy BP; School of Medicine, University of Missouri, Columbia, Missouri, USA., Gilley DR; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA., Clark AD; School of Medicine, University of Missouri, Columbia, Missouri, USA., Galloway TLI; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA., Zitsch RP; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA., Jorgensen JB; Department of Otolaryngology-Head and Neck Surgery and Communication Disorders, School of Medicine, University of Louisville, Louisville, Kentucky, USA., Biedermann GB; Department of Radiation Oncology, School of Medicine, University of Missouri, Columbia, Missouri, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2021 Apr; Vol. 164 (4), pp. 799-806. Date of Electronic Publication: 2020 Sep 22.
DOI: 10.1177/0194599820960137
Abstrakt: Objective: To investigate the relationship between treatment modality and chronic opioid use in a large cohort of patients with head and neck cancer.
Study Design: Retrospective cohort study.
Setting: Single academic center.
Methods: There were 388 patients with head and neck cancer treated between January 2011 and December 2017 who met inclusion criteria. Clinical risk factors for opioid use at 3 and 6 months were determined with univariate and multivariate analyses.
Results: The prevalence of opioid use was 43.0% at 3 months and 33.2% at 6 months. On multivariate analysis, primary chemoradiation (odds ratio [OR], 4.04; 95% CI, 1.91-8.55) and surgery with adjuvant chemoradiation (OR, 2.39; 95% CI, 1.09-5.26) were associated with opioid use at 3 months. Additional risk factors at that time point included pretreatment opioid use (OR, 7.63; 95% CI, 4.09-14.21) and decreasing age (OR, 1.03; 95% CI, 1.01-1.06). At 6 months, primary chemoradiation (OR, 2.40; 95% CI, 1.34-4.28), pretreatment opioid use (OR, 5.86; 95% CI, 3.30-10.38), current tobacco use (OR, 2.00; 95% CI, 1.18-3.40), and psychiatric disorder (OR, 1.79; 95% CI, 1.02-3.14) were associated with opioid use.
Conclusion: Of the patients who receive different treatment modalities, those receiving primary chemoradiation are independently at highest risk for chronic opioid use. Other risk factors include pretreatment opioid use, tobacco use, and a psychiatric disorder. In an effort to reduce their risk of chronic opioid use, preventative strategies should be especially directed to these patients.
Databáze: MEDLINE
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