Pain in head and neck cancer patients: the role of gender.

PURPOSE: To assess the quality of life (QoL) following palliative radiotherapy (RT) in patients with painful bone metastases. METHODS: A literature search limited to English-written publications was carried out, through the Cochrane Central Register of Controlled Trials (November 2018), OvidSP and PubMedCentral (1940-November 2018) databases. Subject headings and keywords included "quality of life"(QoL), "bone metastases", "palliative therapy", "pain" and "radiotherapy". Original articles, literature reviews, trials and meta-analyses revealing alterations in QoL post-RT using ratified measuring tools were examined. Studies referring to other types of metastases (e.g. brain metastases), or to other types of palliative therapy (e.g. the use of bisphosphonates alone), or focusing only on pain, or even reporting QoL only before or only after the use of RT were excluded. RESULTS: Twenty four articles were selected from a total of 1360 articles. Seven trials proceeded to patients' randomization. The most commonly used tool to evaluate QoL was EORTC, followed by Brief Pain Inventory (BPI) and Edmonton Symptom Assessment System (ESAS) questionnaires. All studies showed improvement in symptoms and functional interference scores after RT. The QoL between responders (Rs) and non-responders (NRs) has been juxtaposed in 10 studies. Rs had a significant benefit in QoL in comparison with the NRs. DISCUSSION: Palliative radiotherapy in painful bone metastases improves Rs' QoL.

Pain in head and neck cancer: prevalence and possible predictive factors.

The purpose of this article was to review the main aspects of pain and its prevalence among head and neck cancer patients, as well as to identify the presence of possible pain predictive factors. For an integrated presentation of this topic a Pubmed database systematic search for relevant published studies was performed. When considering the prevalence of pain in head and neck cancer patients the studies available in this field show great variations in relation to the number of patients included, surgical procedures performed, and established approaches to analgesia. Despite the recognized association between cancer and pain, insufficient attention is paid in the head and neck pain problem, and to date, only few studies in the literature address the diagnosis of head and neck pain or its management. Further efforts are necessary in order to understand the real dimension of this problem in head and neck cancer patients, and therefore to recognize pain predictive factors and/or pain genetic factors aiming (i) to identify those subjects most at risk for pain, and (ii) to tailor, in a near future, 'targeted' analgesic interventions.