High Rates of Persistent Opioid Use 6 Months After RT for Cervical Cancer

Nearly 3 in 10 cervical cancer survivors were still using opioids at 6 months after completing radiotherapy, a study presented at the 48th Annual Meeting of the Society of Gynecologic Oncology has shown.¹

In this era of high opioid misuse, the American Society of Clinical Oncology (ASCO) recommends that clinicians consider opioids only for patients with pain who have not responded to conservative management and have persistent disease or functional impairment.

Because patients with active cervical cancer, in particular, have high rates of opioid use, researchers at the University of Colorado in Denver sought to examine patterns of opioid use in cervical cancer survivors.

For the study, investigators analyzed demographic, disease, and treatment data and opioid prescription history from 102 women with cervical cancer treated with radiation between 2011 and 2015 at University of Colorado Hospital. Women whose disease recurred in less than 6 months were not included.

Results showed that 32% and 28% of patients had persistent opioid use at 3 and 6 months after radiotherapy, respectively. Investigators found that patients younger than 40 years, those with disease outside the pelvis, and those with a history of substance abuse or depression and/or anxiety had a significantly higher likelihood of persistent opioid use at 6 months (all P <.05).

Researchers also observed a significant association between opioid use at 6 months and subsequent recurrence or death during the study period (both P <.05).

After adjusting for multiple variables, the study further demonstrated that disease outside the pelvis (odds ratio [OR], 15.06; 95% CI, 1.01-223.73) was associated with a 15-fold higher risk of persistent opioid use at 6 months, while a history of substance abuse (OR, 6.21; 95% CI, 1.08-35.67) and a history of depression and/or anxiety (OR, 6.28; 95% CI 1.70-23.30) increased the likelihood of persistent opioid use by approximately 6 times.

The findings suggest that cervical cancer survivors who have undergone radiation treatment, especially younger patients or those who have a history of anxiety, depression, or substance abuse, may benefit from nonopioid alternative strategies and additional support for pain control.

Reference

1. Ward K, Ramzan AA, Sheeder J, Fischer S, Lefkowits C. Cervical cancer survivors have high rates of persistent opioid use at 6 months after radiation. Paper presented at: 48th Annual Meeting of the Society of Gynecologic Oncology; March 12-15, 2017; National Harbor, MD.