Patient Reported Outcomes/Quality of Life

PV QA 4 - Poster Viewing Q&A 4

TU_43_3737 - Prolonged Opioid Dependence Following Post-Operative Head and Neck Radiation Therapy

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Prolonged Opioid Dependence Following Post-Operative Head and Neck Radiation Therapy
W. H. Smith, B. Scarborough, B. Miles, W. Su, V. Gupta, and R. L. Bakst; Icahn School of Medicine at Mount Sinai, New York, NY

Prolonged Opioid Dependence Following Post-Operative Head and Neck Radiation Therapy

Purpose/Objective(s): Patients undergoing radiation treatment (RT) for head and neck malignancies frequently experience significant radiation-induced pain and odynophagia. Opioids are frequently required to provide sufficient analgesia to complete treatment while maintaining caloric needs and reducing weight loss. However, little work has been done to quantify the risk of prolonged opioid dependence following RT to the head and neck, particularly in the post-operative setting. The goal of this study was to quantify the risk of prolonged opioid dependence among head and neck cancer patients undergoing post-operative RT and to identify associated risk factors.

Materials/Methods: We retrospectively identified patients through our IRB-approved head and neck database who had undergone post-operative RT between Jan 2011 and Sept 2017. Exclusion criteria included chronic pain requiring opioids prior to RT, disease recurrence or further treatment (e.g. salvage surgery) within our study period, incomplete information, loss to follow-up, and RT with palliative intent. Our endpoints were continued opioid dependence at 3- and 6-months following completion of RT, as determined by patient report and EMR prescription records. Univariate analysis and multivariate logistic regression using forward selection were performed to determine which factors were predictive of prolonged opioid use.

Results: We identified 89 patients meeting inclusion criteria. Of these, 59 (66.3%) were prescribed opioids during RT for radiation-induced mucositis and pain. At 3-months and 6-months, 13 (14.6%) and 7 (7.8%) patients had persistent opioid requirements, respectively. On univariate analysis, female sex (p=0.012) and PEG tube (p=0.046) were predictive of opioid use at 3-months; these were no longer significant on multivariate analysis. At 6 months, only larynx/hypopharynx primary (p=0.0192) was predictive of continued opioid use; this effect remained after correction on multivariate regression (p=0.038). However, after correction for multiple hypothesis testing, this result was no longer significant.

Conclusion: While low, the rate of prolonged opioid dependence following post-operative head and neck RT is notable. Given the potential for opioid addiction and concerns regarding long-term opioid use in patients who have completed treatment, clinicians should discuss this risk at the time of initial consult. Our data identifies demographic and treatment related factors predictive of prolonged opioid dependence, which warrant further study.

Author Disclosure: W.H. Smith: None. B. Scarborough: None. B. Miles: None. W. Su: None.

William Smith, MD

Presentation(s):

Send Email for William Smith


Assets

TU_43_3737 - Prolonged Opioid Dependence Following Post-Operative Head and Neck Radiation Therapy



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Prolonged Opioid Dependence Following Post-Operative Head and Neck Radiation Therapy