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This comparative-effectiveness study uses data from 2 clinical trials to evaluate whether the use of gabapentin for pain management is associated with less opioid use and feeding tube placement among adult patients with head and neck cancer receiving chemoradiotherapy. Gabapentin for the treatment of pain related to radiation-induced mucositis in patients with head and neck tumors treated with intensity-modulated radiation therapy Gabapentin appears promising in reducing the need for narcotic pain medication for patients with head and neck malignancies treated with IMRT and should be further evaluated prospectively in controlled clinical trials. This retrospective study evaluated the efficacy of gabapentin for the treatment of pain syndromes related to radiation-induced mucositis in patients with head and neck cancers treated with concurrent chemoradiation. Conclusions: Gabapentin is effective and well-tolerated for the treatment of mucositis-induced pain related to radiation treatment in patients with head and neck cancers, treated with IMRT. We further demonstrate that the use of gabapentin at doses of 2700 mg per day can reduce or eliminate the need for narcotic pain medication. In the context of cancer, gabapentin is often used to manage cancer-related pain, particularly neuropathic pain. This type of pain can result from the cancer itself or as a side effect of treatments like chemotherapy, radiation therapy, or surgery. Gabapentin can help improve the quality of life for cancer patients by reducing pain and discomfort. Abstract Background: This retrospective study evaluated the efficacy of gabapentin for the treatment of pain syndromes related to radiation-induced mucositis in patients with head and neck cancers treated with concurrent chemoradiation. Both S., Quon H. Gabapentin for the treatment of pain related to radiation-induced mucositis in patients with head and neck tumors treated with intensity-modulated radiation therapy. Their discovery, published today in JAMA Network Open, suggests that a prophylactic, or preventative, gabapentin dose of 3600 mg daily can delay or eliminate the need for opioids to manage the pain associated with radiation-induced oral mucositis in patients with head and neck cancer. Findings: No systematic reviews exist on the role of gabapentin for neuropathic pain in radiation-induced OM. Two retrospective studies concluded that gabapentin reduced escalation of opioid doses and unplanned treatment breaks. One retrospective study demonstrated favorable swallowing outcomes. Woman Receiving Radiation Therapy Treatments for Breast Cancer The authors of this review present key epidemiologic data about cancer patients vulnerable for each pain syndrome along with evidence Individuals with cancer experience a host of symptoms, especially when the malignancy is advanced. Pain occurs from the cancer itself or related treatments. Undertreated pain contributes to patient suffering and lack of engagement in cancer-directed therapies. Adequate pain management includes thorough assessment; treatment by radiotherapists or anesthesia pain specialists; anti-inflammatory Risk of bias assessment for included studies Prophylactic gabapentin for pain control during chemoradiation for HNC Gabapentin’s efficacy in the treatment of neuropathic pain makes it a plausible candidate for managing pain secondary to radiation treatment, which can be the result of radiation-induced inflammation, mucositis, or direct nerve injury. The first study meeting the inclusion Patients undergoing radiotherapy for head and neck cancer often develop painful mouth sores caused by inflammation called oral mucositis. The use of prophylactic gabapentin to reduce pain and opioid use during treatment in this population is Most patients tolerated gabapentin well, but those who received the highest dose of gabapentin were significantly less likely to require opioids during radiation therapy—93.1% of patients receiving 900 mg gabapentin required opioids to manage oral mucositis pain, compared to only 37.5% of patients in the 3,600 mg cohort. The novel role that gabapentin may have as a co analgesic to enhance pain management and possibly prevent escalating doses of opioids is included and the nursing implications of treating OM in patients with head and neck cancers receiving RT. Methadone, when used in conjunction with gabapentin, improves pain control and several QoL/function metrics (20, 29). While it is unclear whether high dose gabapentin adds additional benefit to methadone, we recommend the use of methadone for pain relief in patients not well controlled on high dose gabapentin and over-counter-analgesics. Prophylactic use of gabapentin during chemoradiation for HNC patients resulted in a decrease in pain, neurosensory symptoms, and general systemic symptoms. Endogenous chemical irritation Direct tumor invasion with compression of normal tissues. In addition, cancer pain can result from cancer therapies, such as surgery, radiation therapy, and cytotoxic chemotherapy. Types of Pain Management Optimal cancer pain management is determined by the type of cancer and the owner’s goals for treatment. Broadly, 2 potential treatment pathways exist in Randomized Phase 3, Double-Blind, Placebo-Controlled Study of Prophylactic Gabapentin for the Reduction of Oral Mucositis Pain During the Treatment of Oropharyngeal Squamous Cell Carcinoma International Journal of Radiation Oncology, Biology, PhysicsVol. 112Issue 4November 19, 2021
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