Mercadante Sebastiano, Masedu Francesco, Valenti Marco, Aielli Federica
Main Regional Center for Pain, Pain Relief and Supportive/Palliative Care, La Maddalena Cancer Center, 90146 Palermo, Italy.
Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L'Aquila, 67100 L'Aquila, Italy.
J Clin Med. 2020 May 4;9(5):1337. doi: 10.3390/jcm9051337.
To characterize breakthrough cancer pain (BTcP) in patients with lung cancer.
This was a secondary analysis of multicenter study of patients with BTcP. Background pain intensity and opioid dose were recorded. The number of BTcP episodes, their intensity, predictability, onset, duration and interference with daily activities were collected. Opioids used for BTcP, the mean time to meaningful pain relief after taking medication, satisfaction and adverse effects were assessed.
1087 patients with lung cancer were examined. In comparison with other tumors, patients with lung cancer showed: higher background pain intensity ( = 0.006), lower opioid doses ( = 0.005), higher intensity of BTcP ( = 0.005), movement (79.5%) and cough (8.2%), as principal triggers for predictable BTcP ( < 0.009), larger BTcP interference with daily activity ( = 0.0001), higher use of adjuvants ( = 0.0001). No relevant differences in the other parameters examined were found.
Patients with lung cancer have their own peculiarities, including higher basal and BTcP pain intensity and the use of more adjuvant drugs for background pain. The most frequent triggers for predictable BTcP are movement and cough. Future studies should be performed to analyze the prevalence of BTcP in patients with different lung cancers as well as the optimal management strategy for background pain and BTcP.
描述肺癌患者的突破性癌痛（BTcP）特征。
这是一项对BTcP患者进行的多中心研究的二次分析。记录背景疼痛强度和阿片类药物剂量。收集BTcP发作次数、强度、可预测性、发作时间、持续时间以及对日常活动的干扰情况。评估用于BTcP的阿片类药物、服药后获得有效疼痛缓解的平均时间、满意度和不良反应。
对1087例肺癌患者进行了检查。与其他肿瘤患者相比，肺癌患者表现出：更高的背景疼痛强度（P = 0.006）、更低的阿片类药物剂量（P = 0.005）、更高的BTcP强度（P = 0.005），运动（79.5%）和咳嗽（8.2%）是可预测BTcP的主要触发因素（P < 0.009），BTcP对日常活动的干扰更大（P = 0.0001），辅助药物使用更多（P = 0.0001）。在所检查的其他参数方面未发现相关差异。
肺癌患者有其自身特点包括更高的基础疼痛强度和BTcP强度以及针对背景疼痛使用更多辅助药物。可预测BTcP最常见的触发因素是运动和咳嗽。未来应开展研究分析不同类型肺癌患者中BTcP的患病率以及背景疼痛和BTcP的最佳管理策略。
