Loading-dose ibandronate improves opioid-resistant headache in locoregionally advanced nasopharyngeal carcinoma patients prior to concurrent chemoradiotherapy

A considerable proportion of patients with nasopharyngeal carcinoma (NPC) suffer from opioid-resistant headaches due to tumor bone invasion and are often undertreated. Therefore, effective treatment is essential for these patients. Twenty-three patients were included in this study and treated with loading-dose ibandronate (6 mg infused over 30 minutes on 3 consecutive days). The headache severity was reduced within 3-7 days (mean: 4.0 +/- 1.3 days) in these patients. Relative to the baseline, on days 3, 7, and 14, the pain scores were lower (6.3 +/- 1.4 versus 4.7 +/- 2.6, 3.0 +/- 1.7, 2.6 +/- 1.5, respectively; P<0.001) and the analgesic usage was reduced (393.0 +/- 50.7 mg vs. 339.1 +/- 48.1 mg, 243.5 +/- 74.3 mg, 177.4 +/- 84.3 mg, respectively; P<0.001) in the treated patients. These patients did not exhibit hepatic or renal toxicity, and the treatment was well-tolerated. Therefore, this loading-dose ibandronate regimen appears to be a safe and efficacious means of relieving opioid-resistant headaches in NPC patients with bone invasion.