Ostan Rita, Gambino Giuseppe, Malavasi Italo, Ronga Gianluca, Solipaca Maria, Spunghi Michela, Varani Silvia, Pannuti Raffaella, Ruggeri Enrico
National Tumor Assistance (ANT), Via Jacopo di Paolo, 36-40128 Bologna, Italy.
Cancers (Basel). 2021 Nov 16;13(22):5736. doi: 10.3390/cancers13225736.
This observational study aims to evaluate the efficacy of naloxegol therapy in resolving opioid-induced constipation (OIC) and in improving the quality of life in a home palliative care cancer setting. Advanced cancer patients with OIC (Rome IV criteria) not relieved by laxatives started a naloxegol therapy 25 mg/day for 4 weeks. Quality of life was evaluated by Patient Assessment of Constipation Quality-of-Life (PAC-QoL) at day 0 and day 28; background pain by Numerical Rating Scale, number of weekly spontaneous bowel movements and Bowel Function Index (BFI) were evaluated at day 0 and every week. Seventy-eight patients who completed the 4-week study improved all four PAC-QoL dimensions (physical and psychological discomfort, worries/concerns and satisfaction level). Weekly spontaneous bowel movements increased and BFI improved. Background pain reduced after seven days and remained lower during the following weeks. Seventy-two patients dropped out the study before day 28 with a reduced survival compared to patients completing the study. Even in these patients, an improvement of bowel function was observed after two weeks. Naloxegol was effective in improving the quality of life, resolving OIC and reducing overall pain in patients with advanced cancer.
这项观察性研究旨在评估纳洛西醇疗法在居家姑息治疗癌症环境中解决阿片类药物引起的便秘（OIC）以及改善生活质量方面的疗效。符合罗马IV标准且使用泻药无法缓解OIC的晚期癌症患者开始接受每日25毫克纳洛西醇治疗，为期4周。在第0天和第28天通过患者便秘生活质量评估（PAC-QoL）对生活质量进行评估；在第0天和每周通过数字评分量表评估背景疼痛，通过每周自发排便次数和肠功能指数（BFI）进行评估。完成4周研究的78名患者在PAC-QoL的所有四个维度（身体和心理不适、担忧/关注以及满意度水平）均有改善。每周自发排便次数增加，BFI改善。背景疼痛在7天后减轻，并在接下来的几周内保持较低水平。72名患者在第28天前退出研究，其生存期比完成研究的患者短。即便在这些患者中，两周后也观察到肠功能有所改善。纳洛西醇在改善晚期癌症患者的生活质量、解决OIC以及减轻总体疼痛方面有效。
