Kaasa Stein, Apolone Giovanni, Klepstad Pål, Loge Jon Håvard, Hjermstad Marianne Jensen, Corli Oscar, Strasser Florian, Heiskanen Tarja, Costantini Massimo, Zagonel Vittorina, Groenvold Mogens, Fainsinger Robin, Jensen Mark P, Farrar John T, McQuay Henry, Rothrock Nan E, Cleary James, Deguines Catherine, Caraceni Augusto
European Palliative Care Research Centre (PRC), Faculty of Medicine, NTNU, Trondheim, Norway.
BMJ Support Palliat Care. 2011 Dec;1(3):281-7. doi: 10.1136/bmjspcare-2011-000078. Epub 2011 Oct 13.
An increasing number of cancer patients live longer, and palliative care has become an important part of their treatment. Symptoms are often inadequately assessed and managed. A significant challenge in clinical trials is to control for the variability of the samples being studied. To overcome this problem, classification systems have been developed in order to characterise and stratify patients by grouping them according to major common characteristics. The lack of agreed methods for the assessment and classification of cancer pain has been clearly indicated in clinical trials and in clinical practice and may be one possible explanation for the inadequate treatment of cancer pain. This was the background to an international expert meeting arranged in September 2009 in Milan, Italy. The primary aims were to produce recommendations on how to assess and classify cancer pain and to recommend a strategy for the further development, validation and implementation of an international cancer pain classification and assessment system. The recommendations consisted of two basic working proposals, nine specific working proposals and seven recommendations for the further development of a cancer pain classification system. Examples of specific working proposals were to include pain intensity, pain mechanism, breakthrough pain and psychological distress as the core domains in this classification of cancer pain and to measure pain intensity with a 0-10 numerical rating scale with 'no pain' and 'pain as bad as you can imagine' as anchors. The proposed name for this international standard is Cancer Pain Assessment and Classification System (CPACS).
越来越多的癌症患者寿命延长，姑息治疗已成为他们治疗的重要组成部分。症状往往未得到充分评估和处理。临床试验中的一个重大挑战是控制所研究样本的变异性。为克服这一问题，已开发出分类系统，以便根据主要共同特征对患者进行分组，从而对患者进行特征描述和分层。临床试验和临床实践已明确表明，缺乏公认的癌症疼痛评估和分类方法，这可能是癌症疼痛治疗不充分的一个可能原因。这就是2009年9月在意大利米兰召开国际专家会议的背景。主要目的是就如何评估和分类癌症疼痛提出建议，并为国际癌症疼痛分类和评估系统的进一步开发、验证和实施推荐一项策略。这些建议包括两项基本工作提案、九项具体工作提案以及关于癌症疼痛分类系统进一步开发的七项建议。具体工作提案的示例包括将疼痛强度、疼痛机制、爆发性疼痛和心理困扰作为癌症疼痛分类的核心领域，并使用0至10的数字评分量表测量疼痛强度，以“无疼痛”和“尽可能严重的疼痛”作为锚点。这个国际标准的提议名称是癌症疼痛评估和分类系统（CPACS）。
