Neuropathic pain in head and neck cancer patients referred to Specialist Palliative Care services: a cross-sectional observational study

Background: Head and Neck Cancer (HNC) poses a significant disease burden in our population, and Cancer pain is an important therapeutic challenge, with Neuropathic pain (NPP) often underdiagnosed, with worldwide prevalence rates 11% to 55%. The primary objective is to determine the prevalence of NPP in advanced head and neck cancer (HNC) patients referred to Palliative Care services. Methods: This cross-sectional, observational study recruited advanced HNC patients referred to the Department of Palliative Medicine at a tertiary cancer center. NPP, assessed using the DN4 questionnaire. Depression and quality of life (QoL) were assessed using the PHQ-9 and the EORTC-QLQ-C-15-Pal, respectively. Statistical analysis used correlation coefficients and linear regression. Statistical analyses performed using SPSS IBM Corp. Results: We analysed 300 patients, of which 70.3% had NPP; the mean score and S.D. were 4.52 (2.124). Depression was reported in 84% of those with NPP, with a significant correlation between NPP, depression, and QoL (pain domain). Nociceptive pain was present in 29.6%. Oral cavity carcinoma and multimodal treatment were associated factors. Conclusions: NPP is prevalent in patients with advanced HNC. Early detection and timely intervention, including both pharmacological and psychosocial management, will improve patient’s overall well-being. Trial registration: This study was registered with the Clinical Trials Registry India, with the registration number CTRI/2019/08/020636. Date of trial registration: 8th August 2019.