实用医学杂志 ›› 2022, Vol. 38 ›› Issue (24): 3150-3154.doi: 10.3969/j.issn.1006⁃5725.2022.24.023

• 药物与临床 • 上一篇    下一篇

“围放疗期”动态调整盐酸羟考酮缓释片剂量对肺癌骨转移患者镇痛效果的影响 

莫威 曾繁睿 易炜 杨满红 谢亮 何芬 孙建聪    

  1. 广州医科大学附属第一医院放疗科(广州510230)

  • 出版日期:2022-12-25 发布日期:2022-12-25
  • 通讯作者: 孙建聪 E⁃mail:sunjiancong@126.com
  • 基金资助:
    广东省自然科学基金面上项目(编号:2020A1515011454)

Analgesic effect of dynamic adjustment in dose of oxycodone hydrochloride sustained ⁃ release tablets in treatment of metastatic bone pain in lung cancer patients during peri ⁃radiotherapeutic period

MO Wei ZENG Fanrui,YI Wei,YANG Manhong,XIE Liang,HE Fen,SUN Jiancong.   

  1. Department of Radiation Oncology the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510230,China

  • Online:2022-12-25 Published:2022-12-25
  • Contact: SUN Jiancong E⁃mail:sunjiancong@126.com
  • Supported by:

摘要:

目的 探讨肺癌骨转移瘤放疗期间疼痛发作的发生率及动态调整盐酸羟考酮缓释片的临床价值,提高骨转移瘤的诊疗水平。方法 回顾性分析 2018 12 月至 2021 9 月广州医科大学附属 第一医院放疗科收治的 43 例肺癌骨转移患者的临床资料,记录初始疼痛强度评分,放疗后疼痛强度评 分变化及对应盐酸羟考酮缓释片摄入量变化,分析调整盐酸羟考酮缓释片摄入量的止痛疗效和临床价 值。结果 联合治疗止痛有效率为 76.7%(33/43),癌症疼痛完全缓解率为 23.3%(10/43)。肺癌骨转移 放疗期间疼痛加重,疼痛加重 1 次发生率为 20.9%,疼痛加重 2 次发生率为 9.3%(4/43),2 次疼痛加重均需 及时调整盐酸羟考酮药物剂量。放疗后期评估疼痛减轻后逐步减少盐酸羟考酮剂量发生率为 86.04% (37/43),放疗完成后 1 个月内可逐步减少盐酸羟考酮缓释片剂量发生率为 74.41%(32/43),同样均需及时 调整盐酸羟考酮药物剂量。结论 放疗联合阿片类药物是控制癌症疼痛有效治疗手段,肺癌骨转移瘤放 疗期间出现疼痛加重发生率为 20.9%。及时调整盐酸羟考酮缓释片剂量能有效缓解疼痛症状,从而达到 有效镇痛且不滥用阿片类药物最佳平衡。

关键词:

骨转移瘤; , 癌症疼痛; , 放射治疗; , 盐酸羟考酮缓释片; , 动态调整

Abstract:

Objective To explore the incidence of pain flare following radiotherapy for painful bone metas⁃ tases and evaluate the clinical value of dynamic adjustment in dose of oxycodone hydrochloride sustained ⁃ release tablets during peri⁃radiotherapeutic period in treatment of metastasis bone pain in lung cancer. Methods Clinical data of 43 lung cancer patients with metastatic bone pain in our hospital from December 2018 to September 2021 were retrospectively analyzed. Pain score,the changes of pain degrees,and corresponding dose change of oxycodone hydrochloride sustained⁃release tablets during peri⁃radiotherapeutic period were collected to analyze the feasibility and effect of dynamic adjustment of oxycodone hydrochloride sustained⁃release tablets. Results The total analge⁃ sic effective rate of combined treatment was 76.7%(33/43),and the rate of complete relief of cancer pain was 23.3%(10/43). The incidence of single occurrence of pain flare was 20.9%,and that of two times 9.3%(4/43 during peri⁃radiotherapeutic period. The incidence rate of gradual reduction of oxycodone hydrochloride sustained⁃ release tablets dose during peri⁃radiotherapeutic period was 86.04%(37/43),and that of gradual reduction of oxy⁃ codone hydrochloride sustained ⁃ release tablets dose 74.41%(32/43)within 1 month after radiotherapy. Dynamic adjustment in dose of tablets was required during the period. Conclusion Radiotherapy combined with opioids is a well ⁃ established and effective treatment alternative for symptomatic bone metastases. Pain flare is a common event,occurring in 20.9% of the patients receiving radiotherapy for symptomatic bone metastases. Dynamic adjust⁃ ment in dose of oxycodone hydrochloride sustained ⁃ release tablets could improve the efficacy and avoid opioid abuse.

Key words:

bone metastases , cancer pain , radiotherapy , oxycodone hydrochloride sustained? release tablets, dynamic adjustment