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早期使用阿片类药物控制头颈癌患者放疗所致疼痛的优势。

Advantage of early induction of opioid to control pain induced by irradiation in head and neck cancer patients.

作者信息

Takase Hisamitsu, Sakata Toshifumi, Yamano Takafumi, Sueta Takayuki, Nomoto Satoshi, Nakagawa Takashi

机构信息

Department of Pharmacy, Fukuoka University Hospital, Japan.

出版信息

Auris Nasus Larynx. 2011 Aug;38(4):495-500. doi: 10.1016/j.anl.2010.12.012. Epub 2011 Jan 31.

Abstract

OBJECTIVE

Although radiotherapy is effective for head and neck cancer patients, the local pain evoked by the irradiation itself reduces food intake and frequently halts the treatment. Thus, pain control is an important problem in radiotherapy for head and neck cancer. We performed to examine whether early induction of low-dose, opioid from mild pain improves dietary and caloric intake, while reducing weight loss.

METHODS

The subjects were 43 patients who were hospitalized for head and neck cancer from 2004 to 2008. They were patients who underwent radiation treatment but those who did not undergo preoperative treatment. They were divided into two groups, depending on whether the pain was mild or moderate when an opioid was introduced (MILD and MODERATE, N=23 and 20, respectively).

RESULTS

The visual analog scale scores for pain were significantly lower in the MILD than in the MODERATE group at between 25 and 50 Gy. The amount of oxycodone used for pain was significantly lower in the MILD than the MODERATE group. A regular diet was maintained for significantly longer in the MILD group. Caloric intake was significantly higher in the MILD group at over 20 Gy. Weight loss was significantly lower in the MILD group at over 20 Gy. The incidence of side effects was equal in both groups.

CONCLUSION

Our results indicated that the introduction of opioids for mild pain during radiotherapy controls the level of pain, improving food intake in head and neck cancer patients.

摘要

目的

尽管放射治疗对头颈部癌患者有效,但放疗本身引发的局部疼痛会减少食物摄入量,并常常导致治疗中断。因此,疼痛控制是头颈部癌放射治疗中的一个重要问题。我们进行了研究,以检验在轻度疼痛时早期引入低剂量阿片类药物是否能改善饮食和热量摄入,同时减少体重减轻。

方法

研究对象为2004年至2008年因头颈部癌住院的43例患者。他们均接受了放射治疗,但未接受术前治疗。根据引入阿片类药物时疼痛为轻度还是中度,将他们分为两组(轻度组和中度组,分别为N = 23和20)。

结果

在25至50 Gy之间,轻度组的疼痛视觉模拟量表评分显著低于中度组。轻度组用于止痛的羟考酮用量显著低于中度组。轻度组维持正常饮食的时间显著更长。在超过20 Gy时,轻度组的热量摄入显著更高。在超过20 Gy时,轻度组的体重减轻显著更低。两组的副作用发生率相同。

结论

我们的结果表明,在放疗期间对轻度疼痛引入阿片类药物可控制疼痛程度,改善头颈部癌患者的食物摄入量。

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