Jayr Christian
DAAR Institut Gustave-Roussy 39, rue Camille-Desmoulins, 94805 Villejuif.
Bull Cancer. 2004 May;91 Spec No:S125-31.
Traditional pain management strategies for cancer pain have relied on the use of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) and other adjuvant analgesics. However, the substantial adverse effects associated with their use has left many patients without dependable options for effective treatment. Recent advances in the understanding of pain and its pathophysiologic mechanisms have led to the development of novel therapeutics. Cyclooxygenase(Cox)-2-specific inhibitors (coxib) have an established efficacy in the treatment of chronic and acute pain comparable to that of traditional NSAIDs without the degree of gastrointestinal complication or the platelets inhibitor effect of traditional NSAIDs. Numerous studies have shown that coxibs are efficacious in the management of chronic and acute pain in various clinical settings including postoperative pain. The superior safety profile of coxibs in conjunction with a comparable efficacy to nonselective NSAIDs supports the use of coxibs in balanced analgesic regimens and provides the potential to incorporate coxibs into the pain management algorithm used to treat cancer pain.
传统的癌症疼痛管理策略依赖于使用阿片类药物、非甾体抗炎药(NSAIDs)和其他辅助镇痛药。然而,与使用这些药物相关的大量不良反应使许多患者缺乏有效的可靠治疗选择。对疼痛及其病理生理机制认识的最新进展促使了新型疗法的开发。环氧化酶(Cox)-2特异性抑制剂(昔布类)在治疗慢性和急性疼痛方面已确立了疗效,与传统NSAIDs相当,但没有传统NSAIDs那样程度的胃肠道并发症或血小板抑制作用。大量研究表明,昔布类药物在包括术后疼痛在内的各种临床环境中对慢性和急性疼痛的管理有效。昔布类药物优越的安全性概况以及与非选择性NSAIDs相当的疗效,支持将昔布类药物用于平衡镇痛方案,并有可能将昔布类药物纳入用于治疗癌症疼痛的疼痛管理方案中。