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  • br There are some study


    There are some study limitations, due to the secondary analysis of an original trial in patients who were selected for the presence of BTcP. Thus, we do not have information about the prevalence of this phe-nomenon in patients with H&N cancer. Moreover, no specific treatment was given, as treatment was based on local policy. However, data were collected from centers with experienced personnel for the management of background pain and BTcP. Indeed, this data reflects the real world, giving a picture of the characteristics of such patients, as well as the most common analgesic treatments employed for this kind of patients either for background pain or BTcP. The sample was sufficiently num-bered to provide preliminary but solid data. The descriptors for the study AZD-2281 refer only to “H&N cancer”, which is a broad term that refers to an anatomically complex region of the body afflicted with a wide variety of histologies and stages of cancer. Additional information regarding anatomic subsite (oropharynx, parotid gland, larynx, etc), histology (squamous cell, salivary, thyroid, etc), and stages (I, II, III, IV) would enhance the external generalizability of these findings. A better characterization in terms of anticancer intervention could provide more specific data. Thus, a specific study with a larger sample of patients may provide further information about factors influencing background and BTcP presentation.
    In conclusion, BTcP in patients with H&N cancer has its own pe-culiarities, including a larger number of episodes/day and the pre-dictability, particularly with ingestion of food. Transdermal prepara-tions and nasal fentanyl preparations were more likely to be prescribed for background pain and BTcP, respectively, possibly to avoid inter-ference with swallowing or local mucosal damage. Future studies should be performed to analyze the prevalence of BTcP in this popu-lation as well as the optimal management strategy for H&N cancer pain and BTcP.
    The study was sponsored by Molteni, Italy. Data were independently managed by authors.
    Declaration of Competing Interest
    No conflict of interest to be declared.
    The paper is dedicated to prof. Alessandro Sabato and Prof. Antonio Gatti who died during the project.
    Data availability
    The datasets generated during/and or analyzed during the current  Oral Oncology 95 (2019) 87–90
    study are available from the corresponding author on request
    Appendix A. Supplementary material
    [1] Shuman AG, Terrell JE, Light E, et al. Predictors of pain among patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2012;138:1147–54. [2] Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 2011;61:212–36. [3] Taylor JC, Terrell JE, Ronis DL, et al. Disability in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2004;130:764–9. [4] Funk GF, Karnell LH, Christensen AJ. Long-term health-related quality of life in survivors of head and neck cancer. Arch Otolaryngol Head Neck Surg 2012;138:123–33. [5] Osthus AA, Aarstad AK, Olofsson J, Aarstad HJ. Head and neck specific Health Related Quality of Life scores predict subsequent survival in successfully treated head and neck cancer patients: a prospective cohort study. Oral Oncol 2011;47:974–9.
    [6] Lam DK, Schmidt BL. Orofacial pain onset predicts transition to head and neck cancer. Pain 2011;152:1206–9. [7] Talmi YP, Waller A, Bercovici M, et al. Pain experienced by patients with terminal head and neck carcinoma. Cancer 1997;80:1117–23. [8] Epstein JB, Wilkie DJ, Fischer DJ, et al. Neuropathic and nociceptive pain in head and neck cancer patients receiving radiation therapy. Head Neck Oncol 2009;1:26. [9] Chen AM, Hall WH, Li J, et al. Brachial plexus-associated neuropathy after high-dose radiation therapy for head-and-neck cancer. Int J Radiat Oncol Biol Phys 2012;84:165–9. [10] Chua KS, Reddy SK, Lee MC, et al. Pain and loss of function in head and neck cancer survivors. J Pain Symptom Manage 1999;18:193–202. [11] Caraceni A, Portenoy RK. An international survey of cancer pain characteristics and syndromes. IASP Task Force on Cancer Pain. International Association for the Study of Pain. Pain 1999;82:263–74.
    [12] Van den Beuken-van Everdingen MHJ, de Rijke JM, Kessels AG, et al. High pre-valence of pain in patients with cancer in a large population-based study in The Netherlands. Pain 2007;132:312–20.
    [13] Mercadante S. Opioid responsiveness in patients with advanced head and neck cancer. Support Care Cancer 1998;6:482–5. [14] Mercadante S, Casuccio A, Pumo S, Fulfaro F. Opioid responsiveness-primary di-agnosis relationship in advanced cancer patients followed at home. J Pain Symptom Manage 2000;20:27–34.