Hanks G W
Royal Marsden Hospital, London, United Kingdom.
Cancer. 1989 Jun 1;63(11 Suppl):2378-82. doi: 10.1002/1097-0142(19890601)63:11<2378::aid-cncr2820631150>3.0.co;2-8.
The published data relating to the clinical evaluation and use in Europe of oral controlled-release morphine tablets (MST Continus, [MST] Napp Laboratories, United Kingdom) in the treatment of chronic cancer pain are reviewed. There are three evaluable published reports of double-blind randomized controlled studies and a number of prospective open studies and retrospective reviews. There are also several published pharmacokinetic studies and substantial accumulated clinical experience with MST since its introduction in the United Kingdom in 1981. A critical review of the evidence indicates that MST is effective in patients with opioid-responsive pain; that for almost all patients twice-daily administration is sufficient; that the potency ratio compared with standard (immediate-release) oral morphine formulations is one to one; and that the side effect profile is similar. An immediate-release morphine preparation is preferable during the dose titration period when frequent dose adjustment may be required. However, once patients have been stabilized MST is much more convenient and simpler to use than conventional morphine elixirs or tablets and is the preferred formulation for maintenance treatment.
本文回顾了已发表的关于口服控释吗啡片（美施康定，[MST]，纳普实验室，英国）在欧洲用于临床评估及治疗慢性癌痛的相关数据。有三项关于双盲随机对照研究的可评估发表报告，以及一些前瞻性开放研究和回顾性综述。自1981年在英国引入美施康定以来，也有多项已发表的药代动力学研究以及大量积累的临床经验。对现有证据的批判性综述表明，美施康定对阿片类药物反应性疼痛患者有效；几乎所有患者每日两次给药就足够；与标准（即释）口服吗啡制剂相比，效价比为1:1；且副作用情况相似。在可能需要频繁调整剂量的剂量滴定期，即释吗啡制剂更可取。然而，一旦患者病情稳定，美施康定比传统吗啡酏剂或片剂使用起来更方便、更简单，是维持治疗的首选剂型。
