4.6 Review

Prophylactic gabapentin during head and neck cancer therapy: a systematic review and meta-analysis

Journal

SUPPORTIVE CARE IN CANCER
Volume 31, Issue 4, Pages -

Publisher

SPRINGER
DOI: 10.1007/s00520-023-07683-w

Keywords

Gabapentin; Opioids; Systematic review; Meta-analysis; Head and neck cancer

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This review aimed to compile the available evidence on the prophylactic use of gabapentin in head and neck cancer patients. A systematic search identified 10 studies that met the inclusion criteria, which showed that prophylactic gabapentin appears to be a promising treatment option for preventing pain, reducing opioids, and reducing weight loss. However, the studies available are small and have a substantial risk of bias.
PurposeThis review was designed to compile the currently available evidence on the prophylactic use of gabapentin in the head and neck cancer patient population.MethodsA systematic search was conducted of PubMed, Web of Science, and Google Scholar to identify articles related to the use of prophylactic gabapentin in patients undergoing head and neck cancer therapy. Candidate studies were screened for inclusion and a subsequent bias assessment was conducted by multiple reviewers. Meta-analysis was conducted in cases in which the studies used compatible outcome measures.ResultsTen studies were identified that met the inclusion criteria and were assessed for bias. Among the four small studies that examined pain prevention, 2 were positive and 2 were inconclusive. Three of the four studies examiniRDng opioid use noted less need for opioids in the treatment arm. Meta-analysis of the pertinent studies showed no difference in feeding tube placement (RD = 0.64%, 95%CI: (- 25.8%, 27.1%), p = 0.962) but substantially less weight loss among those in the treatment arm (p = 0.047).ConclusionProphylactic gabapentin appears to be a promising treatment option for preventing pain, reducing opioids, and reducing weight loss in patients undergoing head and neck cancer therapy. However, the studies on the treatment to date are small and several have a substantial risk of bias.

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