Persistent Post-radiotherapy Pain and Locoregional Recurrence in Head and Neck Cancer- Is There a Hidden Link?
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Background: To explore the relationship between persistent post-radiotherapy pain and locoregional recurrence in head and neck cancer patients. Methods: Five year retrospective data was reviewed of 86 patients of head and neck cancer treated with radiotherapy who continued to have pain at 6 weeks after completion of treatment. At follow-up after 3 months, these patients were stratified into: Group A (n = 39) constituted of patients whose pain subsided and Group B (n = 47) were patients who continued to have persistent pain. Results: At median follow-up time of 25 months (range: 8−47), one patient (2.6%) and 18 (38.3%) patients in group A and group B had locoregional recurrence respectively (P ＜ 0.0001). Furthermore, group B patients had higher mean pain score levels as compared to group A (P = 0.03). Patients in whom pain subsided within 3 months had statistically much greater disease-free survival in comparison to those with persistent pain (P ＜ 0.0001). Conclusions: Pain in head and neck cancer is an important symptom and should be considered a poor prognostic factor. In the current study, the majority of the patients with persistent pain had recurrent disease as compared to those in whom pain subsided within 3 months of post-treatment. It is suggested that patients with persistent pain need more intense follow-up and should be investigated thoroughly to detect recurrence at an early stage to provide a better quality of life. (Korean J Pain 2015; 28: 116-121)
Abstract
Background: To explore the relationship between persistent post-radiotherapy pain and locoregional recurrence in head and neck cancer patients. Methods: Five year retrospective data was reviewed of 86 patients of head and neck cancer treated with radiotherapy who continued to have pain at 6 weeks after completion of treatment. At follow-up after 3 months, these patients were stratified into: Group A (n = 39) constituted of patients whose pain subsided and Group B (n = 47) were patients who continued to have persistent pain. Results: At median follow-up time of 25 months (range: 8−47), one patient (2.6%) and 18 (38.3%) patients in group A and group B had locoregional recurrence respectively (P ＜ 0.0001). Furthermore, group B patients had higher mean pain score levels as compared to group A (P = 0.03). Patients in whom pain subsided within 3 months had statistically much greater disease-free survival in comparison to those with persistent pain (P ＜ 0.0001). Conclusions: Pain in head and neck cancer is an important symptom and should be considered a poor prognostic factor. In the current study, the majority of the patients with persistent pain had recurrent disease as compared to those in whom pain subsided within 3 months of post-treatment. It is suggested that patients with persistent pain need more intense follow-up and should be investigated thoroughly to detect recurrence at an early stage to provide a better quality of life. (Korean J Pain 2015; 28: 116-121)
참고문헌 (13)
- Ferlay J, "Estimates of worldwide burden of cancer in 2008 : GLOBOCAN 2008", Int J Cancer, 127, pp.2893~2917 (2010)
- Raj PP, "Pain control in cancer of the head and neck. In: Comprehensive management of Head and Neck Tumors", pp.42~68 (1987), WB Saunders
- Foley KM, "The treatment of cancer pain", N Engl J Med, 313, pp.84~95 (1985)
- Epstein JB, "Neuropathic and nociceptive pain in head and neck cancer patients receiving radiation therapy", Head Neck Oncol, 1, pp.26~ (2009)
- Smit M, "Pain as sign of recurrent disease in head and neck squamous cell carcinoma", Head Neck, 23, pp.372~375 (2001)
- Scharpf J, "The role of pain in head and neck cancer recurrence and survivorship", Arch Otolaryngol Head Neck Surg, 135, pp.789~794 (2009)
- Greene FL, "AJCC Cancer Staging Manual", pp.33~46 (2002), Lippincott-Raven
- Hartrick CT, "The numeric rating scale for clinical pain measurement: a ratio measure?", Pain Pract, 3, pp.310~316 (2003)
- Ventafridda V, "WHO guidelines for the use of analgesics in cancer pain", Int J Tissue React, 7, pp.93~96 (1985)
- Therasse P, "Measuring the clinical response. What does it mean?", Eur J Cancer, 38, pp.1817~1823 (2002)
- Chen YH, "Definitive chemoirradiation for resectable head and neck cancer : treatment outcome and prognostic significance of MRI findings", Br J Radiol, 81, pp.490~498 (2008)
- Grond S, "Validation of World Health Organization guidelines for pain relief in head and neck cancer. A prospective study", Ann Otol Rhinol Laryngol, 102, pp.342~348 (1993)
- Cuffari L, "Pain complaint as the first symptom of oral cancer : a descriptive study", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 102, pp.56~61 (2006)