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不可切除胰腺癌患者阿片类药物使用与生存时间的关联:10年临床经验

Association Between Opioid Use and Survival Time in Patients With Unresectable Pancreatic Cancer: 10 Years of Clinical Experience.

作者信息

Oh Tak Kyu, Do Sang-Hwan, Yoon Yoo-Suk, Song In-Ae

机构信息

From the Departments of Anesthesiology and Pain Medicine and.

Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Pancreas. 2018 Aug;47(7):837-842. doi: 10.1097/MPA.0000000000001094.

Abstract

OBJECTIVES

Patients with pancreatic cancer generally experience increasing pain as their disease progresses, making the titration of opioids difficult. This study aimed to determine a correlation between prescribed opioid doses and survival time in patients with unresectable pancreatic cancer.

METHODS

This retrospective observational cohort study in a tertiary care institution reviewed the medical records of patients diagnosed with unresectable pancreatic cancer and treated over a 10-year period.

RESULTS

We screened 1152 patients with unresectable pancreatic cancer, and 566 were eligible for inclusion in this study. There was a statistically significant negative correlation between initial opioid dose and survival time from initial opioid dose (correlation coefficient, -0.184; P < 0.01) and survival time from initial pancreatic cancer diagnosis (correlation coefficient, -0.177; P < 0.01). In addition, there were 0.8% and 0.6% increases in initial opioid dosage (morphine equivalent daily dose) and rate of increasing opioid dose (morphine equivalent daily dose per month), respectively, associated with the risk of early death (≤180 days, P < 0.05).

CONCLUSIONS

Correlations between patient survival, initial opioid dose, final opioid dose, and the rate of increase of opioid dosage could provide useful information for clinicians treating unresectable pancreatic cancer patients.

摘要

目的

胰腺癌患者通常会随着病情进展而疼痛加剧,这使得阿片类药物的滴定变得困难。本研究旨在确定不可切除胰腺癌患者的阿片类药物处方剂量与生存时间之间的相关性。

方法

这项在三级医疗机构进行的回顾性观察队列研究,回顾了在10年期间被诊断为不可切除胰腺癌并接受治疗的患者的病历。

结果

我们筛选了1152例不可切除胰腺癌患者,其中566例符合纳入本研究的条件。初始阿片类药物剂量与自初始阿片类药物剂量起的生存时间(相关系数,-0.184;P < 0.01)以及自初始胰腺癌诊断起的生存时间(相关系数,-0.177;P < 0.01)之间存在统计学上显著的负相关。此外,初始阿片类药物剂量(吗啡等效日剂量)和阿片类药物剂量增加率(每月吗啡等效日剂量)分别增加0.8%和0.6%,与早期死亡风险(≤180天,P < 0.05)相关。

结论

患者生存、初始阿片类药物剂量、最终阿片类药物剂量以及阿片类药物剂量增加率之间的相关性可为治疗不可切除胰腺癌患者的临床医生提供有用信息。

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