{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:49:07Z","timestamp":1788922147025,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Patients with advanced nasopharyngeal carcinoma (ANC) often experience chronic pain. Opioids are generally recommended to treat tumor-related pain, but increased opioid use may lead to detrimental aftereffects, particularly with respect to tumor progression, resulting in reduced quality of life and increased risk of death. Our objective was to investigate whether the high size of opioid prescriptions is associated with poor overall survival (OS) in patients with ANC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A consecutive cohort of patients with newly diagnosed ANC who underwent high or low opioid prescription size treatment during 2012\u20132019 was retrospectively identified from our medical institutions. Survival was estimated with the Kaplan\u2013Meier method with a log-rank test. Multivariate binary logistic regression was used to assess the association between opioid use and OS, adjusting for age, sex, body mass index (BMI), Eastern Collaborative Oncology Group performance status (ECOG PS), and ANC histology. The criterion to distinguish between the high opioid prescription size group [HD] and the low opioid prescription size group [LD] was 5\u00a0mg of oral morphine equivalents (OME) per 24\u00a0hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort consisted of 244 consecutive patients (HD: n = 120, median age = 66 years [range, 40\u201381 years]; LD: n = 124, median age = 65 years [40\u201382\u00a0years]. Patients who underwent treatment with a high opioid prescription size had a worse median OS than those who underwent treatment with a low opioid prescription size (5.1 vs 6.6 months), and the high opioid prescription size was associated with a remarkable 48% higher risk of death than the low opioid prescription size (HR 1.48, 95% CI 1.11\u20131.98;\n                      <jats:italic>P<\/jats:italic>\n                      = .005). The cumulative dose of opioids greater than or equal to 500\u00a0mg of OME was associated with a higher risk of death, adjusted for age, sex, BMI, ECOG PS, and ANC histology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with newly diagnosed ANC experiencing palliative care, a high opioid prescription size may be associated with shorter OS than a low opioid prescription size.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01455613221145093","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T03:09:51Z","timestamp":1670555391000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Survival Outcomes Associated With the Size of Opioid Prescriptions in the Management of Chronic Pain Related to Advanced Nasopharyngeal Carcinoma"],"prefix":"10.1177","volume":"104","author":[{"given":"Kunhong","family":"Li","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Wuhan Fourth Hospital, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Renmin Hospital of Wuhan University, Jiefang Road, Wuchang District, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Tongji Medical College, Huazhong University of Science and Technology, The Central Hospital of Wuhan, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaodong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minji","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, The First Affiliated Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Wuhan Fourth Hospital, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9596-8572","authenticated-orcid":false,"given":"Weiguang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,12,9]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"497","article-title":"Transdermal fentanyl for pain due to chemoradiotherapy-induced oral mucositis in nasopharyngeal cancer patients: evaluating efficacy, safety, and improvement in quality of life","volume":"8","author":"Guo SP","year":"2014","unstructured":"Guo SP, Wu SG, Zhou JN, et al. Transdermal fentanyl for pain due to chemoradiotherapy-induced oral mucositis in nasopharyngeal cancer patients: evaluating efficacy, safety, and improvement in quality of life. 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Morphine stimulates angiogenesis by activating proangiogenic and survival-promoting signaling and promotes breast tumor growth. Cancer Res. 2002;62:4491-4498.","journal-title":"Cancer Res"},{"issue":"1","key":"e_1_3_3_16_2","first-page":"13","article-title":"Morphine stimulates cancer progression and mast cell activation and impairs survival in transgenic mice with breast cancer","volume":"113","author":"Nguyen J","year":"2014","unstructured":"Nguyen J, Luk K, Vang DN, et al. Morphine stimulates cancer progression and mast cell activation and impairs survival in transgenic mice with breast cancer. Br J Anaesth. 2014;113(suppl 1):13.","journal-title":"Br J Anaesth"},{"key":"e_1_3_3_17_2","first-page":"591","article-title":"Impact of Pain, Opioids, and the Mu-opioid Receptor on Progression and Survival in Patients With Newly Diagnosed Stage IV Pancreatic Cancer","volume":"43","author":"Steele GL","year":"2020","unstructured":"Steele GL, Dudek AZ, Gilmore GEN, et al. Impact of Pain, Opioids, and the Mu-opioid Receptor on Progression and Survival in Patients With Newly Diagnosed Stage IV Pancreatic Cancer. 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