Payne R
Pain and Palliative Care Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Oncology (Williston Park). 1998 Nov;12(11A):169-75.
The high prevalence of pain in cancer patients has been appreciated for a long time. However, despite release of cancer pain management guidelines by the Agency for Health Care Policy and Research (AHCPR) in 1994, pain is still undertreated. Recent reports in the literature have identified multiple factors that influence analgesic response and pain management, such as the ethnicity, gender, and age of the patient. Recognition of these factors, and the availability of new drugs, alternative delivery methods, and an enhanced understanding of pain mechanisms and receptor pharmacology compel a revision of the existing cancer pain management guidelines. Assessment and management of pain and other symptoms in cancer patients that influence the quality of survival are increasingly being incorporated into randomized-controlled clinical trials. Strategies should be developed by the National Comprehensive Cancer Network (NCCN) to develop and implement extant and revised pain management guidelines into clinical practice and test new hypotheses regarding pain management treatments in clinical trials.
癌症患者中疼痛的高患病率早已为人所知。然而，尽管医疗保健政策与研究机构（AHCPR）在1994年发布了癌症疼痛管理指南，但疼痛仍未得到充分治疗。文献中的最新报告指出了多种影响镇痛反应和疼痛管理的因素，如患者的种族、性别和年龄。对这些因素的认识，以及新药的出现、替代给药方法，以及对疼痛机制和受体药理学的深入理解，促使人们对现有的癌症疼痛管理指南进行修订。对影响生存质量的癌症患者疼痛及其他症状的评估和管理越来越多地被纳入随机对照临床试验。国家综合癌症网络（NCCN）应制定策略，将现有的和修订后的疼痛管理指南制定并实施到临床实践中，并在临床试验中检验有关疼痛管理治疗的新假设。
