Department of Palliative Medicine, Poznan University of Medical Sciences, Poland.
Curr Pain Headache Rep. 2012 Aug;16(4):307-13. doi: 10.1007/s11916-012-0273-z.
Pain is one of the most frequent and most distressing symptoms in the course of cancer. The management of pain in cancer patients is based on the concept of the World Health Organization (WHO) analgesic ladder and was recently updated with the EAPC (European Association for Palliative Care) recommendations. Cancer pain may be relieved effectively with opioids administered alone or in combination with adjuvant analgesics. Corticosteroids are commonly used adjuvant analgesics and play an important role in neuropathic and bone pain treatment. However, in spite of the common use of corticosteroids, there is limited scientific evidence demonstrating their efficacy in cancer patients with pain. The use of corticosteroids in spinal cord compression, superior vena cava obstruction, raised intracranial pressure, and bowel obstruction is better established than in other nonspecific indications. This review aims to present the role of steroids in pain and management of other symptoms in cancer patients according to the available data, and discusses practical aspects of steroid use.
疼痛是癌症病程中最常见和最令人痛苦的症状之一。癌症患者的疼痛管理基于世界卫生组织(WHO)的镇痛阶梯概念,最近又更新了欧洲姑息治疗协会(EAPC)的建议。阿片类药物单独或联合辅助镇痛药物可有效缓解癌症疼痛。皮质类固醇是常用的辅助镇痛药物,在治疗神经性疼痛和骨痛方面发挥着重要作用。然而,尽管皮质类固醇的应用非常普遍,但在有疼痛的癌症患者中,其疗效的科学证据有限。皮质类固醇在脊髓压迫、上腔静脉阻塞、颅内压升高和肠梗阻中的应用比在其他非特异性适应证中更为确定。本综述旨在根据现有数据介绍皮质类固醇在疼痛和癌症患者其他症状管理中的作用,并讨论皮质类固醇使用的实际问题。
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