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Temporal characterization of acute pain and toxicity kinetics during radiation therapy for head and neck cancer. A retrospective study.
Salama, Vivian; Youssef, Sara; Xu, Tianlin; Wahid, Kareem A; Chen, Jaime; Rigert, Jillian; Lee, Anna; Hutcheson, Katherine A; Gunn, Brandon; Phan, Jack; Garden, Adam S; Frank, Steven J; Morrison, William; Reddy, Jay P; Spiotto, Michael T; Naser, Mohamed A; Dede, Cem; He, Renjie; Mohamed, Abdallah S R; van Dijk, Lisanne V; Lin, Ruitao; Roldan, Carlos J; Rosenthal, David I; Fuller, Clifton D; Moreno, Amy C.
Afiliação
  • Salama V; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Youssef S; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Xu T; Department of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Wahid KA; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Chen J; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Rigert J; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Lee A; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Hutcheson KA; Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Gunn B; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Phan J; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Garden AS; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Frank SJ; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Morrison W; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Reddy JP; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Spiotto MT; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Naser MA; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Dede C; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • He R; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Mohamed ASR; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • van Dijk LV; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Lin R; Department of Radiation Oncology, Medical Center Groningen, University of Groningen, Groningen, NL, USA.
  • Roldan CJ; Department of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Rosenthal DI; Department of Pain Medicine, Division of Anesthesiology, Critical Care Medicine, and Pain Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Fuller CD; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
  • Moreno AC; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
Oral Oncol Rep ; 72023 Sep.
Article em En | MEDLINE | ID: mdl-38638130
ABSTRACT

Objectives:

Pain during Radiation Therapy (RT) for oral cavity/oropharyngeal cancer (OC/OPC) is a clinical challenge due to its multifactorial etiology and variable management. The objective of this study was to define complex pain profiles through temporal characterization of pain descriptors, physiologic state, and RT-induced toxicities for pain trajectories understanding. Materials and

methods:

Using an electronic health record registry, 351 OC/OPC patients treated with RT from 2013 to 2021 were included. Weekly numeric scale pain scores, pain descriptors, vital signs, physician-reported toxicities, and analgesics were analyzed using linear mixed effect models and Spearman's correlation. Area under the pain curve (AUCpain) was calculated to measure pain burden over time.

Results:

Median pain scores increased from 0 during the weekly visit (WSV)-1 to 5 during WSV-7. By WSV-7, 60% and 74% of patients reported mouth and throat pain, respectively, with a median pain score of 5. Soreness and burning pain peaked during WSV-6/7 (51%). Median AUCpain was 16% (IQR (9.3-23)), and AUCpain significantly varied based on gender, tumor site, surgery, drug use history, and pre-RT pain. A temporal increase in mucositis and dermatitis, declining mean bodyweight (-7.1%; P < 0.001) and mean arterial pressure (MAP) 6.8 mmHg; P < 0.001 were detected. Pulse rate was positively associated while weight and MAP were negatively associated with pain over time (P < 0.001).

Conclusion:

This study provides insight on in-depth characterization and associations between dynamic pain, physiologic, and toxicity kinetics. Our findings support further needs of optimized pain control through temporal data-driven clinical decision support systems for acute pain management.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Oral Oncol Rep Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Oral Oncol Rep Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos