Hajj Aline, Halepian Lucine, Osta Nada El, Chahine Georges, Kattan Joseph, Rabbaa Khabbaz Lydia
Laboratory of Pharmacology, Clinical Pharmacy and Quality Control of Drugs, Pôle Technologie- Santé (PTS), Faculty of Pharmacy, Saint-Joseph University, Beirut 1107 2180, Lebanon.
Department of Public Health, Faculty of Medicine, Saint-Joseph University, Beirut 1107 2180, Lebanon.
Int J Mol Sci. 2017 Mar 27;18(4):669. doi: 10.3390/ijms18040669.
Despite increased attention on assessment and management, pain remains the most persistent symptom in patients with cancer, in particular in end-of-life settings, with detrimental impact on their quality-of-life (QOL). We conducted this study to evaluate the added value of determining some genetic and non-genetic factors to optimize cancer pain treatment. Eighty-nine patients were included in the study for the evaluation of palliative cancer pain management. The regression analysis showed that age, single nucleotide polymorphism (SNP), as well as the duration of morphine treatment were significantly associated with morphine doses at 24 h (given by infusion pump; = 0.043, 0.029, and <0.001, respectively). The mean doses of morphine decreased with age but increased with the duration of morphine treatment. In addition, patients with AG genotype c.118A>G needed a higher dose of morphine than AA patients. Moreover, metastases, SNP, age, and gender were significantly associated with the QOL in our population. In particular, AA patients for SNP had significantly lower cognitive function than AG patients, a result not previously reported in the literature. These findings could help increase the effectiveness of morphine treatment and enhance the QOL of patients in regards to personalized medicine.
尽管对评估和管理的关注度有所提高,但疼痛仍然是癌症患者最持久的症状,尤其是在临终阶段,对他们的生活质量(QOL)产生不利影响。我们开展这项研究以评估确定一些遗传和非遗传因素对优化癌症疼痛治疗的附加价值。89名患者纳入本研究以评估姑息性癌症疼痛管理。回归分析表明,年龄、单核苷酸多态性(SNP)以及吗啡治疗时长与24小时吗啡剂量显著相关(通过输液泵给药;分别为P = 0.043、0.029和<0.001)。吗啡平均剂量随年龄降低,但随吗啡治疗时长增加。此外,携带c.118A>G的AG基因型患者比AA基因型患者需要更高剂量的吗啡。此外,转移、SNP、年龄和性别与我们研究人群的生活质量显著相关。特别是,携带SNP的AA基因型患者的认知功能明显低于AG基因型患者,这一结果此前未见文献报道。这些发现有助于提高吗啡治疗的有效性,并在个性化医疗方面提高患者的生活质量。