Variations in pain prevalence, severity, and analgesic use by duration of survivorship: a cross-sectional study of 505 post-treatment head and neck cancer survivors.

Autor: Ren JL; Department of Emergency Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Room Z9.3018, Zayed Building for Personalized Cancer Care, 6565 MD Anderson Blvd., Houston, TX, 77030, USA.; Baylor College of Medicine, Houston, TX, 77030, USA., Rojo RD; Department of Emergency Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Room Z9.3018, Zayed Building for Personalized Cancer Care, 6565 MD Anderson Blvd., Houston, TX, 77030, USA.; College of Medicine, University of the Philippines Manila, 1000, Manila, Philippines., Perez JVD; College of Medicine, University of the Philippines Manila, 1000, Manila, Philippines., Yeung SJ; Department of Emergency Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Room Z9.3018, Zayed Building for Personalized Cancer Care, 6565 MD Anderson Blvd., Houston, TX, 77030, USA., Hanna EY; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA., Reyes-Gibby CC; Department of Emergency Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Room Z9.3018, Zayed Building for Personalized Cancer Care, 6565 MD Anderson Blvd., Houston, TX, 77030, USA. creyes@mdanderson.org.; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. creyes@mdanderson.org.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2021 Dec 06; Vol. 21 (1), pp. 1304. Date of Electronic Publication: 2021 Dec 06.
DOI: 10.1186/s12885-021-09024-8
Abstrakt: Background: Studies suggest a high prevalence of pain in head and neck cancer (HNC) patients at diagnosis, during and after treatment; however, these studies had small sample sizes and did not comprehensively assess factors known to influence pain. We surveyed a large cohort of HNC survivors to determine variations in the prevalence of pain, its treatment and management by duration of survivorship, and assessed a comprehensive list of risk factors.
Methods: A cross sectional survey of post-treatment survivors of HNC during routine follow-up clinic visits.
Results: A total of 505 HNC survivors with a median follow up of 3 years from cancer diagnosis were included in the study. Overall, 45% (n = 224) reported pain and 14.5, 22 and 7% reported use of prescribed pain medication, over-the-counter pain medication and alternative pain therapies, respectively. Prevalence of severe pain was 7.3% and did not vary significantly by years of survivorship (< 1 year = 5.7%; 1 to < 3 years = 7.1%; 3 to < 8 years = 7.6%; 8 years or more =9.7%; P = 0.392). However, use of prescribed pain medication significantly varied by years of survivorship (< 1 year = 45.7%; 1 to < 3 years = 24.6%; 3 to < 8 years = 18.9; 8 years or more = 18.3%; p < 0.001). Of note, a significant proportion of survivors reported moderate to severe pain (moderate to severe = 55.7% versus none to mild = 44.3%) despite step 3 analgesic use (p < 0.001). Multivariable regression shows that recurrent disease (OR 6.77, 95% CI [1.44, 31.80]), history of chemotherapy (OR 6.00, 95% CI [2.10, 17.14]), and depression (Mild-moderate OR 5.30, 95% CI [2.20, 12.78]; Major OR 8.00, 95% CI [2.67, 23.96]) were significant risk factors for severe pain.
Conclusions: We identified a high prevalence of pain among HNC survivors and determined that analgesic use varied by the duration of survivorship. Therefore, routine surveillance for pain must be consistent throughout the course of survivorship.
(© 2021. The Author(s).)
Databáze: MEDLINE
Externí odkaz: