Chronic opioid use occurs in head and neck cancer patients on radiation therapy

Patients with head and neck cancer who undergo radiation therapy tend to have persistent opioid use, reveals a study, noting further investigation on early intervention to appropriately wean patients.

A group of researchers reviewed the medical records of patients with head and neck cancer who received radiation therapy from January 2012 to July 2016 to characterize the incidence of chronic opioid dependence and to identify patient and treatment factors associated with persistent use.

All patients received 60‒70 Gy with curative intent. Those who progressed or died within 1 year were excluded. Opioid doses were calculated in morphine equivalent daily doses in milligrams (mg). Finally, associations between demographic, medical, disease, and persistent opioid use were determined using univariate and multivariate regression models.

Overall, 261 patients were eligible for analysis. The median follow-up was 39 months. Of the patients, 211 (80 percent) received opioid for pain control during radiation, with a median morphine equivalent daily dose of 73.8 mg during treatment.

Persistent opioid use rates were 41.8 percent at 6 months from completion of radiation, 30.1 percent at 1 year, and 26.0 percent at 2 years. Multivariate analysis revealed that only preradiation opioid use was associated with persistent opioid use at all three time points (p<0.05). Smoking history and a Charlson comorbidity index ≥2 were predictive of persistent opioid use at some, but not all, time points.