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Gabapentin delayed narcotic use for mucositis from oropharyngeal cancer
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Patients with oropharyngeal cancer undergoing radiation therapy experienced delayed initiation of narcotic use for pain from mucositis when treated with gabapentin, according to study results presented at the 2014 Oncology Nursing Society Annual Congress.
The analysis included 68 patients who received radiation therapy for oropharyngeal cancer at an NCI-designated cancer center between 2010 and 2013. Of these patients, 24 received a gastrostomy tube, 25 received a gastrostomy tube plus gabapentin (Neurontin; Pfizer), and 19 received gabapentin alone.
Mean weight loss was lower among patients who received gabapentin alone (6.36%) or with a gastrostomy tube (7.99%) compared with those who only received a gastrostomy tube (8.02%), but these differences were not statistically significant (P=.44).
Onset for grade 2 mucositis was shortest among patients who received gabapentin alone (19 days), followed by those who received both interventions (24 days), and a gastrostomy tube alone (31 days; P˂.01). Onset for grade 3 mucositis varied between the arms (gastrostomy tube, 36 days; gastrostomy tube plus gabapentin, 31 days; gabapentin, 34 days; P=.54).
Mean time to initiation of narcotic use was longest among patients who received a gastrostomy tube plus gabapentin (33 days) or gabapentin alone (28 days) compared with those who only received a gastrostomy tube (19 days; P˂.01).
Overall, patients who received gabapentin alone had the earliest incidence of grade 2 mucositis (P˂.05), although patients who did not receive gabapentin required significantly earlier use of narcotics for mucositis compared with patients who received a gastrostomy tube and gabapentin (P˂.05).
“The use of gabapentin is an effective way to manage and prevent pain,” the researchers wrote. “The patients using gabapentin had an earlier time to grade 2 mucositis, yet initiated narcotic use later. These outcomes demonstrate the need for a rigorous, randomized control trial to increase the generalizability of the results.”
For more information:
Afonso S. A retrospective analysis of gabapentin therapy in the management and prevention of pain in oropharyngeal cancer patients treated with radiation therapy. Presented at: Oncology Nursing Society Annual Congress; May 1-4, 2014; Anaheim, Calif.
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.