Hyun Myung Soo, Lee Jae Lyun, Lee Kyung Hee, Shin Sei One, Kwon Ki Young, Song Hong Suk, Kim Ok Bae, Sohn Sang Kyun, Lee Kyu Bo, Rhu Hun Mo, Park Gun Wook, Shin Dong Gun, Lee Jeong Lim
Department of Internal Medicine, Division of Hematology-Oncology, College of Medicine, Yeungnam University, 317-1 Dae-Myeong-Dong, Nam-Gu, Daegu 705-710, South Korea.
Oncology. 2003;64(3):237-44. doi: 10.1159/000069314.
Substantial pain is experienced by a lot of patients with cancer, and undertreated pain significantly undermines their quality of life. Despite international and national guidelines on cancer pain management, the practical effectiveness of management is still problematic. We did a prospective cross-sectional survey on pain prevalence, pain intensity, its impact on daily activity, and adequacy of pain management in 823 patients treated by medical oncologists and radiologic oncologists. At the time of the survey, 29.7% of the patients had pain that was moderate or severe. Performance status and tumor extent were significant predictors of pain presence and its intensity. Pain severity and the proportion of the patients whose function is impaired are highly associated. Among the patients with pain, only 37% rated pain relief as satisfactory. Forty-one percent of the patients with pain received inadequate pain management. Physicians did not adjust the analgesic prescription in about 53% of the patients who reported severe pain. These results demonstrate the alarming degree of undertreatment of pain in patients with cancer in Korea, and indicate the need to improve the management of cancer-related pain. Future research should elucidate the factors that impede adequate pain management in order to overcome obstacles to adequate treatment.
许多癌症患者都经历着剧烈疼痛，而疼痛治疗不足会严重损害他们的生活质量。尽管有国际和国家关于癌症疼痛管理的指南，但管理的实际效果仍存在问题。我们对823名接受医学肿瘤学家和放射肿瘤学家治疗的患者进行了一项关于疼痛患病率、疼痛强度、其对日常活动的影响以及疼痛管理充分性的前瞻性横断面调查。在调查时，29.7%的患者有中度或重度疼痛。体能状态和肿瘤范围是疼痛存在及其强度的重要预测因素。疼痛严重程度与功能受损患者的比例高度相关。在有疼痛的患者中，只有37%的人认为疼痛缓解令人满意。41%有疼痛的患者疼痛管理不足。在报告严重疼痛的患者中，约53%的患者医生未调整镇痛处方。这些结果表明韩国癌症患者疼痛治疗不足的程度令人担忧，并表明需要改善癌症相关疼痛的管理。未来的研究应阐明阻碍充分疼痛管理的因素，以克服充分治疗的障碍。
