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Objective <p>This study evaluated the effects of diversified pain management strategies, including pre-rehabilitation exercises, auricular seed embedding, and five-tone therapy, delivered within an integrated care model on pain control, complication rates, functional status, and nutritional maintenance among patients with nasopharyngeal carcinoma (NPC) undergoing chemoradiotherapy.</p> Method <p>A non-concurrent controlled study was conducted at a tertiary care center, enrolling 108 eligible patients with NPC treated between August 2023 and February 2025. Following 1:1 nearest-neighbor propensity score matching (PSM), 104 patients were included in the final analysis (52 in the control group and 52 in the intervention group). The control group received conventional pain management, while the intervention group received pain management integrated within a coordinated care model. Pain intensity was assessed using the Numerical Rating Scale (NRS). Complication rates, including oral mucositis, dysphagia, and cervical muscle stiffness, were recorded. Additional outcomes included Karnofsky Performance Status (KPS) scores, daily dosage of sustained-release oxycodone hydrochloride tablets, and body weight changes. Multivariate regression analysis was performed to adjust for potential residual confounding factors.</p> Results <p>After PSM, the intervention group demonstrated significantly lower NRS scores at week 4 (2.18 vs. 3.25; mean difference = 1.07; 95% CI 0.78–1.36; <i>P</i> &lt; 0.001) and week 7 (1.73 vs. 2.35; mean difference = 0.61; 95% CI 0.31–0.92; <i>P</i> &lt; 0.001) compared to the control group. The combined complete and partial pain remission rate was markedly higher in the intervention group at week 4 (92.31% vs. 21.15%) and remained elevated at week 7 (84.62% vs. 71.15%; <i>P</i> &lt; 0.05). The incidence of oral mucositis (73.08% vs. 88.46%), Grade III or higher dysphagia (13.46% vs. 28.85%), and neck muscle stiffness (11.54% vs. 26.92%) was significantly lower in the intervention group (<i>P</i> &lt; 0.05 for all), while no significant difference was observed in the incidence of radiation dermatitis (<i>P</i> &gt; 0.05). KPS scores were consistently higher in the intervention group from week 1 (79.64 vs. 75.58; <i>P</i> = 0.028) through week 7 (77.68 vs. 67.69; mean difference = 9.99; 95% CI: 6.91–13.06; <i>P</i> &lt; 0.001). The mean daily dosage of sustained-release oxycodone hydrochloride was lower in the intervention group at week 4 (25.80&#xa0;mg vs. 30.67&#xa0;mg; <i>P</i> = 0.003) and week 7 (24.21&#xa0;mg vs. 33.12&#xa0;mg; <i>P</i> &lt; 0.001). In addition, the intervention group maintained stable body weight (+ 0.12&#xa0;kg) during treatment, whereas the control group experienced weight loss (−1.03&#xa0;kg; <i>P</i> &lt; 0.001 for interaction effect), although no significant difference in discharge weight was observed between groups (<i>P</i> = 0.426). Multivariate regression analysis confirmed that the integrated care model was independently associated with improvements across key clinical outcomes (<i>P</i> &lt; 0.05 for all).</p> Conclusion <p>Implementation of diversified pain management strategies within an integrated care model was associated with enhanced analgesia, reduced complication rates, preservation of functional capacity, decreased opioid requirements, and nutritional stability among patients with NPC undergoing chemoradiotherapy. These findings underscore the potential of coordinated supportive care in this clinical context. Large-scale, multicenter randomized controlled trials are warranted to confirm these associations and further investigate the underlying mechanisms.</p>

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Impact of diversified pain management strategies within an integrated care model in patients with nasopharyngeal carcinoma undergoing chemoradiotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月10日

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  • Bi-Hua Lin,
  • Xiu-Ming Chen,
  • Gui-Zhen Weng,
  • Qiu-Yan Zhang,
  • Hai-Ying Deng,
  • Xiao-Yan Chen,
  • Yan-Juan Lin

摘要

Objective

This study evaluated the effects of diversified pain management strategies, including pre-rehabilitation exercises, auricular seed embedding, and five-tone therapy, delivered within an integrated care model on pain control, complication rates, functional status, and nutritional maintenance among patients with nasopharyngeal carcinoma (NPC) undergoing chemoradiotherapy.

Method

A non-concurrent controlled study was conducted at a tertiary care center, enrolling 108 eligible patients with NPC treated between August 2023 and February 2025. Following 1:1 nearest-neighbor propensity score matching (PSM), 104 patients were included in the final analysis (52 in the control group and 52 in the intervention group). The control group received conventional pain management, while the intervention group received pain management integrated within a coordinated care model. Pain intensity was assessed using the Numerical Rating Scale (NRS). Complication rates, including oral mucositis, dysphagia, and cervical muscle stiffness, were recorded. Additional outcomes included Karnofsky Performance Status (KPS) scores, daily dosage of sustained-release oxycodone hydrochloride tablets, and body weight changes. Multivariate regression analysis was performed to adjust for potential residual confounding factors.

Results

After PSM, the intervention group demonstrated significantly lower NRS scores at week 4 (2.18 vs. 3.25; mean difference = 1.07; 95% CI 0.78–1.36; P < 0.001) and week 7 (1.73 vs. 2.35; mean difference = 0.61; 95% CI 0.31–0.92; P < 0.001) compared to the control group. The combined complete and partial pain remission rate was markedly higher in the intervention group at week 4 (92.31% vs. 21.15%) and remained elevated at week 7 (84.62% vs. 71.15%; P < 0.05). The incidence of oral mucositis (73.08% vs. 88.46%), Grade III or higher dysphagia (13.46% vs. 28.85%), and neck muscle stiffness (11.54% vs. 26.92%) was significantly lower in the intervention group (P < 0.05 for all), while no significant difference was observed in the incidence of radiation dermatitis (P > 0.05). KPS scores were consistently higher in the intervention group from week 1 (79.64 vs. 75.58; P = 0.028) through week 7 (77.68 vs. 67.69; mean difference = 9.99; 95% CI: 6.91–13.06; P < 0.001). The mean daily dosage of sustained-release oxycodone hydrochloride was lower in the intervention group at week 4 (25.80 mg vs. 30.67 mg; P = 0.003) and week 7 (24.21 mg vs. 33.12 mg; P < 0.001). In addition, the intervention group maintained stable body weight (+ 0.12 kg) during treatment, whereas the control group experienced weight loss (−1.03 kg; P < 0.001 for interaction effect), although no significant difference in discharge weight was observed between groups (P = 0.426). Multivariate regression analysis confirmed that the integrated care model was independently associated with improvements across key clinical outcomes (P < 0.05 for all).

Conclusion

Implementation of diversified pain management strategies within an integrated care model was associated with enhanced analgesia, reduced complication rates, preservation of functional capacity, decreased opioid requirements, and nutritional stability among patients with NPC undergoing chemoradiotherapy. These findings underscore the potential of coordinated supportive care in this clinical context. Large-scale, multicenter randomized controlled trials are warranted to confirm these associations and further investigate the underlying mechanisms.