Uses of analgesia for mucositis in chemoradiotherapy of the head and neck region

—With a focus on IACRT—

Abstract

In chemoradiotherapy (CRT) for head and neck cancer, oral mucositis is an inevitable adverse event. We analyzed the use of opiates in head and neck cancer treated by CRT or IACRT (intra-arterial chemoradiotherapy). Strong opioids were used in half of all cases. The pain scale when the strong opioid was started was 5 on average (0 to 10, numerical rating scale). Strong opioids were started at an average of 26.8Gy irradiation in total, compared with at 20Gy in IACRT cases. The average mucositis grade was 2.15 in total, but it become stronger in IACRT cases, whose average was 2.26. In the case of IACRT, strong opioids must be considered at an early stage of therapy, because it likely causes more severe local mucositis at an early stage.