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A systematic review of orofacial pain in patients receiving cancer therapy

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An Erratum to this article was published on 04 November 2010

Abstract

Purpose

We present the findings of a structured systematic review of the literature assessing orofacial pain induced by malignant disease and/or its therapy (excluding mucositis). This evaluation of the literature published after the 1989 NIH Development Consensus conference on the oral complications of cancer therapies is an effort to assess the prevalence of pain, quality of life and economic impact, and management strategies for cancer therapy-induced orofacial pain.

Methods

A systematic medical literature search was conducted with assistance from a research librarian in MEDLINE/PubMed and EMBASE databases for articles published between January 1, 1990 and December 31, 2008. Each study was independently assessed by two reviewers with expertise in the field of oral oncology.

Results

Thirty-nine studies assessed pain in the head and neck region. The measure was commonly embedded in quality of life studies. Most of these studies described pain in head and neck cancer (HNC) patients, which therefore became the focus of the report.

Pain is common in patients with HNC and is reported by approximately half of patients prior to cancer therapy, 81% during therapy, 70% at the end of therapy, and by 36% at 6 months after treatment. Pain is experienced beyond the 6-month period by approximately one third of patients and is typically more severe than pre-treatment cancer-induced pain.

Conclusions

This systematic review identified the presence of pain before cancer therapy, likely attributable to the cancer; an increase in pain during therapy and the common persistence of pain following cancer treatment. Continuing research should use validated tools to prospectively assess orofacial pain, its causes and pathophysiology, and its effect on quality of life and economic impact. Clinical trials of pain management in this setting are also warranted.

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Conflict of interest statement

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Author information

Authors and Affiliations

  1. Department Oral Medicine and Diagnostic Sciences, Otolaryngology and Head and Neck Surgery and Cancer Center, MC 838, University of Illinois, Chicago, IL, 60612, USA

    Joel B. Epstein

  2. Department of Oral Medicine, Carolinas Medical Center, P. O. Box 32861, Charlotte, NC, 28232, USA

    Catherine Hong

  3. Oral Pathology, School of Dentistry, Faculty of Health Sciences, The University of Adelaide, Consultant Oral Pathologist, Division of Surgical Pathology, SA Pathology, Adelaide, Australia

    Richard M. Logan

  4. Department of General Dental Sciences, University of Alabama at Birmingham, SDB 111, Birmingham, AL, 35294-0007, USA

    Andrei Barasch

  5. University of Maryland, 650W Baltimore St., Baltimore, MD, USA

    Sharon M. Gordon

  6. Scripps Center for Dental Care, 9850 Genesee Ave, La Jolla, CA, 92037, USA

    Lorree Oberlee-Edwards

  7. University of Maryland School of Nursing, Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Cancer Center, 655 West Lombard Street, 325B, Baltimore, MD, 21201, USA

    Deborah McGuire

  8. Department of Oral Medicine, Carolinas Medical Center, P. O. Box 32861, Charlotte, NC, 28232, USA

    Joel J. Napenas

  9. Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Linda S. Elting

  10. Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RG, Groningen, The Netherlands

    Fred K. L. Spijkervet

  11. Department of Oral Medicine, Carolinas Medical Center, P. O. Box 32861, Charlotte, NC, 28232, USA

    Michael T. Brennan

Authors
  1. Joel B. Epstein
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  2. Catherine Hong
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  3. Richard M. Logan
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  7. Deborah McGuire
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  8. Joel J. Napenas
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  9. Linda S. Elting
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  10. Fred K. L. Spijkervet
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  11. Michael T. Brennan
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Corresponding author

Correspondence to Joel B. Epstein.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00520-010-1026-3

Appendix

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Table 3 Levels and sources of evidence
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Epstein, J.B., Hong, C., Logan, R.M. et al. A systematic review of orofacial pain in patients receiving cancer therapy. Support Care Cancer 18, 1023–1031 (2010). https://doi.org/10.1007/s00520-010-0897-7

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  • DOI: https://doi.org/10.1007/s00520-010-0897-7

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