Xing, S.Z., & Zhang, Y. (2015). Efficacy and safety of transdermal fentanyl for the treatment of oral mucositis pain caused by chemoradiotherapy in patients with esophageal squamous cell carcinoma. Supportive Care in Cancer, 23, 753–759.

DOI Link

Study Purpose

To investigate the efficacy and safety of transdermal fentanyl for mucositis pain caused by chemoradiotherapy in patients with esophageal squamous cell carcinoma

Intervention Characteristics/Basic Study Process

Forty-six patients with moderate to severe oral mucositis receiving chemoradiotherapy for esophageal squamous cell carcinoma were given transdermal fentanyl for pain management.

Sample Characteristics

  • N = 46
  • MEAN AGE = 56.3 years (range = 42–72 years)
  • Males: 32%, Females: 12%
  • KEY DISEASE CHARACTERISTICS: Pain management with transdermal fentanyl for the patients who developed oral mucositis during chemoradiotherapy from October 2010 to December 2012
  • OTHER KEY SAMPLE CHARACTERISTICS: Patients with painful mucositis had pain scores greater than or equal to 4 or oral mucositis grade more than 1.

Setting

  • SITE: Single site
  • LOCATION: Binzhou Medical University, China

Phase of Care and Clinical Applications

  • PHASE OF CARE: Transdermal fentanyl treatment

Study Design

This was an unblinded, nonrandomized study.

Measurement Instruments/Methods

Pain scores on a Numeric Rating Scale (NRS), the National Cancer Institute's Common Toxicity Criteria, administration frequency of transdermal fentanyl, and post-treatment adverse effects data were analyzed using SPSS. The paired sample Wilcoxon signed rank test was used to evaluate differences before and after treatment, quality of life, nutritional status, and oral hygiene.

Results

The NRS pain scores were p < 0.0001 before and after treatment. Significant differences (p < 0.001) were observed between the indices of quality of life. 15.2% of patients reported nausea and vomiting, 13% developed dizziness, and 10.9% complained of gastric discomfort. All these symptoms were mild and disappeared after proper management.

Conclusions

In this study, transdermal fentanyl was effective in reducing pain from oral mucositis caused by chemoradiotherapy.

Limitations

  • The first study was performed in one center only.
  • Sample size small
  • Sample not randomized or controlled 
  • Short-term observations included.
  • Inconsistent administration of opioids

Nursing Implications

Nurses should be aware of the benefits of transdermal fentanyl but also should be aware of its side effects and half-life so they can educate and support patients in pain.