Pain Relief & Palliative Care Unit, La Maddalena Cancer Center, Via San Lorenzo 312, 90145 Palermo, Italy.
Lung Cancer. 2010 Apr;68(1):10-5. doi: 10.1016/j.lungcan.2009.11.004. Epub 2009 Dec 16.
This review analyses the characteristics of the principal pain syndromes associated with lung cancer, their physiopathology and causes, and provides updated information on available treatments. Pain associated with lung cancer is characterized by multiple expressions, due to either the progression of disease and/or induced by oncological treatment. The analgesic treatment is principally based on the use of opioids. Other than the oral route, which is the preferred one, alternative modalities to administer opioids may be helpful in different clinical circumstances. According to the opioid response, other routes and other opioids, may improve the balance between analgesia and adverse effects providing the best individual response to a specific opioid drug. More complex strategies, such as interventional procedures, are seldom necessary and require an appropriate selection of patients.
本文分析了与肺癌相关的主要疼痛综合征的特征、病理生理学和病因,并提供了关于现有治疗方法的最新信息。肺癌相关疼痛表现多样,可能是由于疾病进展和/或肿瘤治疗引起。镇痛治疗主要基于阿片类药物的应用。除了首选的口服途径外,在不同的临床情况下,替代阿片类药物的给药方式可能会有所帮助。根据阿片类药物的反应,其他途径和其他阿片类药物可能会改善镇痛效果和不良反应之间的平衡,为特定阿片类药物提供最佳的个体反应。更复杂的策略,如介入性操作,很少有必要,并需要对患者进行适当的选择。