Effect of treatment modality on chronic opioid use in patients with T1/T2 oropharyngeal cancer

Head Neck. 2019 Apr;41(4):892-898. doi: 10.1002/hed.25482. Epub 2019 Jan 10.

Abstract

Background: The effect of treatment modality on long-term opioid dependence in patients with oropharyngeal cancer has not been reported.

Methods: A retrospective cohort of 122 patients with T1/T2 oropharyngeal cancer undergoing treatment was generated. Risk factors associated with chronic opioid use were investigated by univariate and multivariate analyses.

Results: The prevalence of chronic opioid use was 45.9%. On multivariate analysis, primary nonsurgical treatment (odds ratio [OR] 4.5, 95% confidence interval [CI]: 1.7-11.4), pretreatment opioid use (OR 14.9, 95% CI: 3.5-62.5), psychiatric disorder (OR 4.3, 95% CI: 1.03-18.5), alcohol use (OR 2.6, 95% CI: 1.03-6.5), and younger age (OR 1.1, 95% CI: 1.02-1.11) were significantly associated with chronic opioid use.

Conclusion: Primary nonsurgical treatment, younger age, pretreatment opioid use, alcohol use, and psychiatric disorder were independently associated with an increased risk of chronic opioid use. Preventative strategies should be especially focused toward these patients to reduce their risk of long-term opioid use.

Keywords: TORS; chronic opioid use; oropharyngeal cancer; perioperative pain; quality of life.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Analysis of Variance
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy / adverse effects
  • Chemoradiotherapy / methods*
  • Chronic Disease
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Opioid-Related Disorders / epidemiology*
  • Oropharyngeal Neoplasms / pathology*
  • Oropharyngeal Neoplasms / therapy*
  • Pharyngectomy / adverse effects
  • Pharyngectomy / methods
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Statistics, Nonparametric
  • Treatment Outcome
  • United States