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大麻在癌症疼痛管理中的实际应用考量——肿瘤内科医生应了解的内容

Practical Considerations for the Use of Cannabis in Cancer Pain Management-What a Medical Oncologist Should Know.

作者信息

Gorzo Alecsandra, Havași Andrei, Spînu Ștefan, Oprea Adela, Burz Claudia, Sur Daniel

机构信息

Department of Medical Oncology, The Oncology Institute "Prof. Dr. Ion Chiricuţă", 400015 Cluj-Napoca, Romania.

Department of Medical Oncology, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania.

出版信息

J Clin Med. 2022 Aug 27;11(17):5036. doi: 10.3390/jcm11175036.

Abstract

Pain is a highly debilitating emotional and sensory experience that significantly affects quality of life (QoL). Numerous chronic conditions, including cancer, are associated with chronic pain. In the setting of malignancy, pain can be a consequence of the tumor itself or of life-saving interventions, including surgery, chemotherapy, and radiotherapy. Despite significant pharmacological advances and awareness campaigns, pain remains undertreated in one-third of patients. To date, opioids have been the mainstay of cancer pain management. The problematic side effects and unsatisfactory pain relief of opioids have revived patients' and physicians' interest in finding new solutions, including cannabis and cannabinoids. The medical use of cannabis has been prohibited for decades, and it remains in Schedule 1 of the Misuse of Drugs Regulations. Currently, the legal context for its usage has become more permissive. Various preclinical and observational studies have aimed to prove that cannabinoids could be effective in cancer pain management. However, their clinical utility must be further supported by high-quality clinical trials.

摘要

疼痛是一种极具致残性的情绪和感官体验,会显著影响生活质量(QoL)。包括癌症在内的众多慢性疾病都与慢性疼痛相关。在恶性肿瘤的情况下,疼痛可能是肿瘤本身造成的后果,也可能是包括手术、化疗和放疗在内的挽救生命的干预措施导致的。尽管在药理学方面取得了重大进展并开展了宣传活动,但仍有三分之一的患者疼痛未得到充分治疗。迄今为止,阿片类药物一直是癌症疼痛管理的主要手段。阿片类药物存在的不良副作用以及止痛效果不尽人意,重新唤起了患者和医生寻找新解决方案的兴趣,其中包括大麻和大麻素。大麻的医疗用途已被禁止数十年,并且仍然列在《药物滥用法规》的附表1中。目前,其使用的法律环境已变得更加宽松。各种临床前和观察性研究旨在证明大麻素在癌症疼痛管理中可能有效。然而,其临床效用必须通过高质量的临床试验得到进一步支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dfa/9457511/45cc0fc1f3ca/jcm-11-05036-g001.jpg

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