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口咽癌患者放疗及放化疗期间的疼痛管理:单机构经验

Pain management during radiotherapy and radiochemotherapy in oropharyngeal cancer patients: single-institution experience.

作者信息

Konopka-Filippow Monika, Zabrocka Ewa, Wójtowicz Aleksandra, Skalij Piotr, Wojtukiewicz Marek Z, Sierko Ewa

机构信息

Department of Radiotherapy, Comprehensive Cancer Center in Bialystok, Bialystok, Poland.

Department of Oncology, Medical University of Bialystok, Bialystok, Poland.

出版信息

Int Dent J. 2015 Oct;65(5):242-8. doi: 10.1111/idj.12181. Epub 2015 Sep 12.

Abstract

AIM OF THE STUDY

Radiotherapy (RT) is a radical therapeutic option for patients with oropharyngeal cancer (OPC). It induces an acute postradiation reaction that may cause significant pain. The aim of this study was to analyse pain occurrence and intensity, as well as type and effectiveness of analgesic treatment, in OPC patients undergoing RT or radiochemotherapy (RT-CT).

MATERIAL AND METHODS

Retrospective data were obtained for 42 OPC patients at clinical stages I-IVA, treated with adjuvant RT or RT-CT or definite RT or RT-CcT at the Comprehensive Cancer Center in Bialystok, Poland. Pain intensity and type of analgesic treatment during the therapy were analysed and compared with the intensity of the radiation-induced acute reaction, assessed weekly according to the Dische score.

RESULTS

Thirty-nine (92.9%) patients received analgesic treatment. Analgesic therapy was started in 27 (64.3%) patients with administration of non-steroidal anti-inflammatory drugs (NSAIDs) and/or paracetamol, in seven (16.7%) with mild opioids and in five (11.9%) with strong opioids. Strong opioids were used during therapy in 21 (50%) patients. Co-analgesics were administered to six patients. Breakthrough pain was observed in 10 (23.8%) patients.

CONCLUSIONS

High incidence of pain during RT and RT-CT calls for increased awareness of the importance of pain monitoring and treatment during RT of OPC patients. The analgesic treatment had to be adjusted individually.

摘要

研究目的

放射治疗(RT)是口咽癌(OPC)患者的一种根治性治疗选择。它会引发急性放疗后反应,可能导致严重疼痛。本研究的目的是分析接受RT或放化疗(RT-CT)的OPC患者的疼痛发生情况、强度以及镇痛治疗的类型和效果。

材料与方法

获取了波兰比亚韦斯托克综合癌症中心42例临床I-IVA期OPC患者的回顾性数据,这些患者接受了辅助RT或RT-CT或确定性RT或RT-CcT治疗。分析了治疗期间的疼痛强度和镇痛治疗类型,并与根据迪斯评分每周评估的放射诱导急性反应强度进行比较。

结果

39例(92.9%)患者接受了镇痛治疗。27例(64.3%)患者开始使用非甾体抗炎药(NSAIDs)和/或对乙酰氨基酚进行镇痛治疗,7例(16.7%)使用轻度阿片类药物,5例(11.9%)使用强效阿片类药物。21例(50%)患者在治疗期间使用了强效阿片类药物。6例患者使用了辅助镇痛药。10例(23.8%)患者出现了爆发性疼痛。

结论

RT和RT-CT期间疼痛的高发生率要求提高对OPC患者RT期间疼痛监测和治疗重要性的认识。镇痛治疗必须个体化调整。

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