|
With nearly all patients who undergo treatment for cancers of the head and neck experiencing oral mucositis, or painful mouth sores, effective pain control is one of the main goals of physicians and care teams. Looking to provide more effective relief for patients while also reducing the need for opioid painkillers, a team from Roswell Park Comprehensive Cancer Center explored whether gabapentin, a drug used to relieve nerve pain and treat seizures, could be an effective alternative to narcotics in managing treatment-related symptoms for these patients. Their results, published in the journalรย Cancer, show that gabapentin is an effective alternative to standard pain-control drugs and that many patients with head and neck cancers had their pain and symptoms managed without any narcotics.
 |
| Dr. Anurag Singh of Roswell Park Comprehensive Cancer Center |
Anurag K. Singh, MD, Professor of Oncology and Director of Radiation Research at Roswell Park, led the study, in which 60 patients with squamous cell carcinoma of the head and neck were randomly assigned to one of two treatment arms: highรขโฌยdose gabapentin (2,700 mg daily), progressing successively to hydrocodone-acetaminophen and fentanyl when needed, or to a regimen of lowรขโฌยdose gabapentin (900รย mg daily), progressing to methadone when needed.
The researchers, who include first authorรย Gregory Hermann, MD, MPH, a resident physician in radiation medicine at Roswell Park, report two key findings: that highรขโฌยdose prophylactic gabapentin increased the percentage of patients who required no opioid during treatment รขโฌโ from 7% among those receiving the low-dose regimen to 42% in the high-dose arm รขโฌโ and that methadone may improve quality of life compared to a regimen of shortรขโฌยacting opioids such as hydrocodone and fentanyl, a synthetic opioid.
รขโฌลWe learned some important things here,รขโฌย says Dr. Singh, the studyรขโฌโขs senior author. รขโฌลThis was a pilot study, but our results were so striking that we have already changed our practice at Roswell Park. Weรขโฌโขre now going to high-dose gabapentin as our first intervention for patients dealing with the effects of treatment for head-and-neck cancer. And for those whose pain progresses on gabapentin, we now know that methadone รขโฌโ an inexpensive, widely available narcotic รขโฌโ is more effective, less likely to impair quality of life and less likely to lead to addiction than other opioids.รขโฌย
The study represents the latest evidence from Roswell Park demonstrating safe and effective alternatives that can significantly reduce the need for opioids in clinical care. Last year, Roswell Park implemented new pain-management guidelines for patients undergoing surgery based onรย researchรย led by Emese Zsiros, MD, PhD, showing that patients recovered well after surgery when prescribed few or no opioids.
Dr. Singh and team have another clinical study underway (NCT03574792) that seeks to determine whether incorporatingรย venlafaxine hydrochloride, a drug commonly prescribed to treat depression, into pain management may further reduce the need for narcotics in patients treated for head and neck cancers.
The study inรย Cancerรย is available atรย https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.32676. This research benefitted from shared resources supported by Roswell Parkรขโฌโขs Cancer Center Support Grant from the National Cancer Institute (project no. P30CA016056).
###
For an online version of this release, please visit:รย https://www.roswellpark.org/newsroom/202001-alternative-pain-control-strategy-reduces-need-opioids-patients-head-neck-cancer
Roswell Park Comprehensive Cancer Center is a community united by the drive to eliminate cancerรขโฌโขs grip on humanity by unlocking its secrets through personalized approaches and unleashing the healing power of hope. Founded by Dr. Roswell Park in 1898, it is the only National Cancer Institute-designated comprehensive cancer center in Upstate New York. Learn more atรย www.roswellpark.org,รย or contact us at 1-800-ROSWELL (1-800-767-9355) orรย ASKRoswell@RoswellPark.org.รย
|
