Korean J Pain.  2015 Apr;28(2):116-121. 10.3344/kjp.2015.28.2.116.

Persistent Post-radiotherapy Pain and Locoregional Recurrence in Head and Neck Cancer-Is There a Hidden Link?

• Srivastava P
• Kingsley P
• Srivastava H
• Sachdeva J
• Kaur P

• KMID: 2278272
• DOI: http://doi.org/10.3344/kjp.2015.28.2.116

Abstract

BACKGROUND
To explore the relationship between persistent post-radiotherapy pain and locoregional recurrence in head and neck cancer patients.
METHODS
Five year retrospective data was reviewed of 86 patients of head and neck cancer treated with radiotherapy who continued to have pain at 6 weeks after completion of treatment. At follow-up after 3 months, these patients were stratified into: Group A (n = 39) constituted of patients whose pain subsided and Group B (n = 47) were patients who continued to have persistent pain.
RESULTS
At median follow-up time of 25 months (range: 8-47), one patient (2.6%) and 18 (38.3%) patients in group A and group B had locoregional recurrence respectively (P < 0.0001). Furthermore, group B patients had higher mean pain score levels as compared to group A (P = 0.03). Patients in whom pain subsided within 3 months had statistically much greater disease-free survival in comparison to those with persistent pain (P < 0.0001).
CONCLUSIONS
Pain in head and neck cancer is an important symptom and should be considered a poor prognostic factor. In the current study, the majority of the patients with persistent pain had recurrent disease as compared to those in whom pain subsided within 3 months of post-treatment. It is suggested that patients with persistent pain need more intense follow-up and should be investigated thoroughly to detect recurrence at an early stage to provide a better quality of life.

Keyword

Disease-free survival; Follow-up studies; Head and neck neoplasms; Local recurrence; Pain; Quality of life

MeSH Terms

Disease-Free Survival
Follow-Up Studies
Head and Neck Neoplasms
Head*
Humans
Neck*
Quality of Life
Radiotherapy
Recurrence*
Retrospective Studies

Figure

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  Fig. 1 Study Design: 86 (26.7%) patients had experienced pain at 6 weeks after the completion of treatment. At 3 months follow-up, pain subsided in 39 patients and 47 patients had persistent pain.

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  Fig. 2 Kaplan Meier curve for Disease-free survival.

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