First author | Publ. year | Location | Inclusion Criteria | Exclusion Criteria | Active group | Comparison group | Duration/ Follow-up |
---|---|---|---|---|---|---|---|
Castro et al. 2003 [38] | 2003 | North America | Histologically confirmed recurrent, refractory HNSCC. Tumours > 0.5 cm3 and > 20 cm3. Prior course of cancer therapy | NYHAC III or IV cardiovascular symptoms; cardiac arrhythmias; extracranial carotid vascular disease; known hypersensitivity to components. Tumours with immediate risk of haemorrhage, embolization, or uncontrolled local infection at the treatment site. Fibrotic lesions, and tumours that directly involving or threatening carotid artery | CDDP/epi gel injected into the tumour at 0.25 ml gel/cm3 of tumour volume | Placebo gel containing 0.9% NaCl injected into target tumour, similar dose to active gel | 5 ½ years |
Georgiou et al. 2000 [39] | 2000 | Greece | Final stage of the disease, suffered pain uncontrolled by oral morphine | Not mentioned | Cervical epidural catheter inserted and bolus of morphine given | Thoracic epidural catheter inserted and bolus of morphine given | 10 days |
Jovic et al. 2008. [40] | 2008 | Serbia | Operations for HNC | Preoperative analgesics, allergy to NSAIDS, history of peptic ulcer and coagulopathy | Ketoprofen 100 mg IV every 8 hours for the first 3 - 5 days | 2.5 mg IV Metamizole every 8 hours for the first 3 - 5 days | 3 days |
McNeely et al. 2004 [47] | 2004 | Canada | HNSCC managed by definitive surgical resection also metastatic spread. Radical neck dissection and variants. Medical diagnosis of shoulder dysfunction caused by spinal accessory neurapraxiaeurectomy and evidence of trapezius dysfunction | Reported comorbid shoulder pathology and/or had a medical illness or psychiatric illness. No distant mets, no evidence of residual cancer in the neck | PRET- exercise 3 times a week. Exercises individualized to suit each subject. 6 exercises in total | Standard care exercise program | 12 weeks |
McNeely et al. 2008 [27] | 2008 | Canada | HNSCC for surgical treatment, radical neck dissection, modified radical neck dissection, other variants of selective neck dissection; Karnofsky performance status ≥ 60%. No evidence of residual cancer in the neck and no distant metastasis; completion of adjuvant HNC treatment. Symptoms of shoulder dysfunction from spinal accessory nerve damage | Shoulder or neck pathology unrelated to cancer treatment, comorbid medical illness or psychiatric illness preventing completion. | PRET- 2 sets of 10 - 15 repetitions of 5 - 8 exercises | TP = supervised active and passive ROM, stretching postural and strengthening exercises with light weights and elastic resistance bands. | 12 weeks |
Pfister et al. 2010 [48] | 2010 | North America | Neck dissection; expressed com- plaints of pain and/or dysfunction in the neck and/or shoulders from neck dissection; > 3 months since neck dissection and radiation; only moderate and severe pain/ dysfunction | Received acupuncture and oriental medicine | Acupuncture once a week for 4 weeks Needles inserted 0.25 to 0.5 inches and retained for 30 minutes. | Physical therapy, analgesics and anti-inflammatories | 4 weeks |
Plantevin et al. 2007 [41] | 2007 | France | Lateral transmandibular pharyngectomy or partial glossectomy under GA | Severe renal/hepatic impairment, heart failure, chronic respiratory disease, contraindications to regional anaesthesia, inability to understand PCA, ASA physical classification status > III, age < 18 years | Preoperatively MNB | Deep s.c. injection of normal saline pre-operatively | 48 hours post surgery |
Roussier et al. 2006 [42] | 2006 | France | Undergoing elective laryngeal surgery for cancer with tracheostomy | Chronic pain or opioid dependence, contraindications to cervical epidural catheter, inability to understand PCA, chronic respiratory impairment, ASA physical classification status IV or V, age < 18 years | Patient controlled epidural Fentanyl, loading dose of Fentanyl 1.5 mg kg-1, maintenance dose 25 mg lockout interval 10 min | Patient Controlled IV Fentanyl, PCA identical with epidural pump | 48 hours post surgery |
Saxena et al. 1994 [43] | 1994 | India | Continuous pain at tumour site, NRS > 3 | Bleeding from any site, surgery in preceding 10 days, renal/hepatic impairment, intermittent pain, communication difficulties | Piroxicam 20 mg 12 hourly | ASA 500 mg 6 hourly | 4 days |
Singhal et al. 2006 [44] | 2006 | India | ASA status I and II, age range 25 - 60 years. For oral cancer surgery with PMMF reconstruction | Chronic pain, chronic opioid use, drug/alcohol abuse, chronic headache, backache, peripheral neuropathy, low platelet count (< 100 000/mm3), deranged bleeding/clotting time. | 3 mg of Morphine and 10 ml Saline through epidural in T8/T9 interspace every 12 hours | 3 mg Morphine intravenously when VAS score > 30 | 48 hours post surgery to discharge |
Werner et al. 2002 [45] | 2002 | Europe and Israel | Histologically confirmed, recurrent or refractory, primary or metastatic HNSCC. Only problematic tumours | NYHAC III or IV cardiovascular symptoms, history of cardiac arrhythmia, head and neck tumour not of squamous cell origin, history of extracranial carotid vascular disease. | CDDP/epi gel injected into target tumour, at 0.25 ml cm-3 of treated tumour volume. | Placebo gel containing 0.9% Saline injected into target tumour, at similar dose to active gel. | 6 months |
Wittekindt et al. 2006 [46] | 2006 | Germany | Tumor recurrence-free survival of 18 months or longer | Neurological diseases causing chronic pain in the neck and shoulder | 0.1 mL BtxA solution injected per site, 10 MU per site in low-dose group | 0.1 mL BtxA solution injected per site, 20 MU per site in high-dose group | 28 days |
Yagi et al. 1997 [35] | 1997 | Japan | Postoperative patients for head and neck cancer surgery | No information | IV Fentanyl at a rate of 10 mg per hour. 20 mg Piroxicam after anaesthesia every 24 hours for 2 days | Received analgesics: Pentazocine i.m, suppository Diclofenac sodium judged by a surgeon when patient complained of pain | 48 hours |
ASA = acetylsalicylic acid; MNB = mandibular nerve block; CDDP/epi gel = intratumoral cisplatin/epinephrine injectable gel; PCA = patient controlled analgesia; HNC = head and neck cancer; VAS = Visual Analogue Scale; NRS = Numerical Rating Scale; PMMF = pectoralis major myocutaneous flap; IV = intravenous; s.c. = control subcutaneous; GA = general anaesthesia; ROM = range of motion; HNSCC = squamous cell carcinoma of the head and neck; PRET = progressive resistance exercise training; TP = exercise protocol. |