• Paolo Bossi, Laura Locati, Cristiana Bergamini, Aurora Mirabile, Roberta Granata, Martina Imbimbo, Carlo Resteghini, and Lisa Licitra.
• Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: paolo.bossi@istitutotumori.mi.it.
• Oral Oncol. 2014 Sep 1;50(9):884-7.

BackgroundPainful mucositis is one of the most distressing toxicities of chemoradiotherapy (CRT) for head and neck cancer (HNC), with the characteristics of incidental predictable breakthrough pain (BTP) during swallowing. Fentanyl pectin nasal spray (FPNS) could be a good therapeutic option.MethodsPatients were prospectively considered if receiving basal analgesic therapy with opiates for painful mucositis of grade ⩾4 on a numerical rating scale from 0 to 10. They were offered FPNS 100mcg before oral intake. When patients reached the effective dose, they evaluated the basal pain intensity before FPNS use and after 10, 20, 30 and 40min.ResultsSeventeen HNC patients were offered FPNS before oral intake, with 15 patients completing treatment. Mean reduction of incidental BTP intensity after FPNS was 3.1 points (range 1.2-5.8). Mean time elapsed since FPNS use and highest pain reduction was 26min.ConclusionsFPNS demonstrated activity against BTP when swallowing in HNC patients. These data should be considered as hypothesis-generating.Copyright © 2014 Elsevier Ltd. All rights reserved.

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