Krakowski Ivan, Theobald Serge, Balp Laurent, Bonnefoi Marie-Pierre, Chvetzoff Giselle, Collard Olivier, Collin Elisabeth, Couturier Monique, Delorme Thierry, Duclos Roseline, Eschalier Alain, Ffergane Bernard, Larue Francois, Magnet Marc, Minello Christian, Navez Marie-Louise, Richard Anne, Richard Bruno, Rostaing-Rigattieri Sylvie, Rousselot Hubert
FNCLCC, Standards, Options, Recommandations, 101, rue de Tolbiac, 75654 Paris Cedex 13, France.
Bull Cancer. 2002 Dec;89(12):1067-74.
The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of french cancer centers (FNCLCC), the 20 French cancer centers, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery.
To develop clinical practice guidelines for the use of medical analgesics for the treatment of pain arising from excess nociception in adults with cancer according to the definitions of the Standards, Options and Recommendations project.
In 1996, a working group, set up by the FNCLCC published clinical practice guidelines for pain management in adult and paediatric patients with cancer. In the light of the evolution of our knowledge, and practice these guidelines need to be updated. The section on "medical analgesic treatments" in the document published in 1996 was examined by the working group to identify which questions should be updated. These questions and the relevant key words were used to develop a search strategy which was used to search Medline , and for particular questions, Embase , from January 1994 to March 1999, for relevant references, published in English or French.
For this update, only a few randomised clinical trials were identified, and their conclusions were generally weak. Thus much of the information in this document is based on the World Health Organisation (WHO) guidelines and represents the "state of the art" on this subject in France and is supported by expert agreement. Some changes to the original SOR are presented, eg. methods of titration, prescription of new opioids, opioid rotation. We also present a synthesis of recent pharmacological and regulatory data. The integral version is available on the FNCLCC web site (http://www.fnclcc.fr/sor.htm).
“标准、选项与建议”（SOR）项目始于1993年，是法国癌症中心联合会（FNCLCC）、20家法国癌症中心以及法国公立大学、综合医院和私立诊所的专家之间的合作项目。其主要目标是制定临床实践指南，以提高医疗保健质量和癌症患者的治疗效果。该方法基于多学科专家小组的文献综述和批判性评估，并结合癌症护理专家的反馈意见。
根据“标准、选项与建议”项目的定义，制定关于使用医用镇痛药治疗成年癌症患者因伤害性感受过强而引起疼痛的临床实践指南。
1996年，FNCLCC设立的一个工作组发布了成年和儿童癌症患者疼痛管理的临床实践指南。鉴于我们知识和实践的发展，这些指南需要更新。工作组审查了1996年发布文件中“医用镇痛治疗”部分，以确定哪些问题需要更新。这些问题及相关关键词被用于制定检索策略，该策略用于检索1994年1月至1999年3月期间发表在Medline以及针对特定问题检索Embase上的英文或法文相关参考文献。
对于此次更新，仅识别出少数随机临床试验，且其结论通常说服力不足。因此，本文件中的许多信息基于世界卫生组织（WHO）的指南，代表了法国在该主题上的“最新技术水平”，并得到了专家共识的支持。文中介绍了对原始SOR的一些更改，例如滴定方法、新型阿片类药物的处方、阿片类药物轮换。我们还提供了近期药理学和监管数据的综述。完整版本可在FNCLCC网站（http://www.fnclcc.fr/sor.htm）上获取。
