Simone Charles B, Vapiwala Neha, Hampshire Margaret K, Metz James M
Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Int J Radiat Oncol Biol Phys. 2008 Sep 1;72(1):127-33. doi: 10.1016/j.ijrobp.2008.03.071. Epub 2008 Jun 9.
Pain is a common symptom among cancer patients, yet many patients do not receive adequate pain management. Few data exist quantifying analgesic use by radiation oncology patients. This study evaluated the causes of pain in cancer patients and investigated the reasons patients fail to receive optimal analgesic therapy.
An institutional review board-approved, Internet-based questionnaire assessing analgesic use and pain control was posted on the OncoLink (available at www.oncolink.org) Website. Between November 2005 and April 2006, 243 patients responded. They were predominantly women (73%), white (71%), and educated beyond high school (67%) and had breast (38%), lung (6%), or ovarian (6%) cancer. This analysis evaluated the 106 patients (44%) who underwent radiotherapy.
Of the 106 patients, 58% reported pain from their cancer treatment, and 46% reported pain directly from their cancer. The pain was chronic in 51% and intermittent in 33%. Most (80%) did not use medication to manage their pain. Analgesic use was significantly less in patients with greater education levels (11% vs. 36%, p = 0.002), with a trend toward lower use by whites (16% vs. 32%, p = 0.082) and women (17% vs. 29%, p = 0.178). The reasons for not taking analgesics included healthcare provider not recommending medication (87%), fear of addiction or dependence (79%), and inability to pay (79%). Participants experiencing pain, but not taking analgesics, pursued alternative therapies for relief.
Many radiation oncology patients experience pain from their disease and cancer treatment. Most study participants did not use analgesics because of concerns of addiction, cost, or failure of the radiation oncologist to recommend medication. Healthcare providers should have open discussions with their patients regarding pain symptoms and treatment.
疼痛是癌症患者的常见症状，但许多患者并未得到充分的疼痛管理。关于放射肿瘤学患者镇痛药使用情况的量化数据很少。本研究评估了癌症患者疼痛的原因，并调查了患者未能接受最佳镇痛治疗的原因。
一份经机构审查委员会批准的、基于互联网的评估镇痛药使用和疼痛控制情况的问卷发布在OncoLink网站（www.oncolink.org）上。2005年11月至2006年4月期间，有243名患者回复。他们主要为女性（73%）、白人（71%），高中以上学历（67%），患有乳腺癌（38%）、肺癌（6%）或卵巢癌（6%）。本分析评估了106名接受放疗的患者（44%）。
在106名患者中，58%报告因癌症治疗而疼痛，46%报告直接因癌症而疼痛。疼痛为慢性的占51%，间歇性的占33%。大多数（80%）患者未使用药物来管理疼痛。受教育程度较高的患者镇痛药使用显著较少（11%对36%，p = 0.002），白人（16%对32%，p = 0.082）和女性（17%对29%，p = 0.178）有使用较少的趋势。不服用镇痛药的原因包括医疗保健提供者未推荐药物（87%）、害怕成瘾或依赖（79%）以及无力支付（79%）。经历疼痛但未服用镇痛药的参与者寻求替代疗法来缓解疼痛。
许多放射肿瘤学患者因疾病和癌症治疗而经历疼痛。大多数研究参与者未使用镇痛药是因为担心成瘾、费用或放疗肿瘤学家未推荐药物。医疗保健提供者应与患者就疼痛症状和治疗进行坦诚的讨论。
