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一项关于纳洛美丁治疗胸部癌症患者阿片类药物引起的便秘的疗效和安全性的回顾性研究。

A retrospective study of the efficacy and safety of naldemedine for opioid-induced constipation in thoracic cancer patients.

机构信息

Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan.

Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Japan.

出版信息

Thorac Cancer. 2022 Aug;13(16):2301-2308. doi: 10.1111/1759-7714.14557. Epub 2022 Jul 5.

Abstract

BACKGROUND

We conducted a multicenter, retrospective study on the efficacy and safety of naldemedine in thoracic cancer patients using opioids in clinical practice.

METHODS

We retrospectively evaluated thoracic cancer patients treated with naldemedine at 10 institutions in Japan. Clinical data of patients administered naldemedine between June 2017 and August 2019 were extracted from electronic medical records. Inclusion criteria were as follows: (i) patients hospitalized for at least seven days before and after naldemedine administration, and (ii) those whose frequency of defecation was entered in the medical records.

RESULTS

Forty patients were analyzed, and defecation frequency was observed for at least seven days before and after naldemedine administration. The response rate was 65.0% (95% CI: 50.2%-79.7%). The number of defecations increased significantly after naldemedine administration in the overall population, as well as among only those who defecated <3 times/week before naldemedine administration, and those that were administered ≥30 mg/day of morphine equivalent. Diarrhea was the most common adverse event in all grades, occurring in 11 patients (27.5%), of which 9 (81.8%) were grade 1 or 2. None of the patients experienced grade 4 or higher adverse events.

CONCLUSION

The efficacy and safety of naldemedine for thoracic cancer patients in clinical practice were comparable with those of prospective studies, which suggest that naldemedine may be effective and feasible for most thoracic cancer patients.

摘要

背景

我们在临床实践中进行了一项多中心、回顾性研究,评估纳洛酮治疗使用阿片类药物的胸癌患者的疗效和安全性。

方法

我们回顾性评估了日本 10 家机构使用纳洛酮治疗的胸癌患者。从电子病历中提取了 2017 年 6 月至 2019 年 8 月期间接受纳洛酮治疗的患者的临床数据。纳入标准如下:(i)患者在使用纳洛酮前后至少住院 7 天,(ii)病历中记录了排便频率。

结果

共分析了 40 例患者,在使用纳洛酮前后至少观察了 7 天的排便频率。总体人群的缓解率为 65.0%(95%CI:50.2%-79.7%)。纳洛酮治疗后,总体人群以及在纳洛酮治疗前每周排便次数<3 次和每天给予≥30mg 吗啡当量的患者中,排便次数显著增加。所有级别中最常见的不良反应是腹泻,共有 11 例患者(27.5%)发生,其中 9 例(81.8%)为 1 级或 2 级。无患者发生 4 级或更高级别不良反应。

结论

纳洛酮治疗胸癌患者的疗效和安全性与前瞻性研究相当,这表明纳洛酮可能对大多数胸癌患者有效且可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e4a/9376157/375bb1b10efe/TCA-13-2301-g001.jpg

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