氨酚羟考酮联合局部放疗对老年恶性肿瘤骨转移癌痛患者血清细胞因子的影响

doi:10.3969/j.issn.1006-5725.2025.11.016

Abstract

Abstract:

Objective To investigate the influence of combination of oxycodone-acetaminophen and local radiotherapy on serum cytokines in elderly patients with malignant tumor bone metastasis and cancer pain. Methods Eighty elderly patients with malignant tumor bone metastasis and cancer pain admitted to Huainan Xinhua Medical Group Xinhua Hospital from January 2020 to April 2024 were divided into control group （40 cases） and observation group （40 cases） according to the order of admission. The control group received codeine combined with local radiotherapy， whereas the observation group was treated with oxycodone-acetaminophen combined with local radiotherapy. Pain relief （assessed using visual analogue scale （VAS））， daily fulminant pain occurrence frequency and occurrence of adverse reactions during treatment as well as serum cytokines ［substance P （SP）， prostaglandinE2 （PGE2）， interleukin-6 （IL-6）］， sleep quality （assessed using Pittsburgh sleep quality index （PSQI）） and quality of life ［assessed using functional assessment of cancer therapy-general （FACT-G）］ before and after treatment were compared between the two groups.. Results The pain relief effect in the observation group was better （P < 0.05）， and the daily occurrence frequency of fulminant pain was less than that in the control group （P < 0.05）. After treatment， serum levels of SP， PGE2 and IL-6 in the observation group were lower compared to those in the control group （P < 0.05）. The total incidence rate of bone-related events during treatment was not significantly different between the two groups （P > 0.05）， and the total incidence rate of adverse reactions was lower in the observation group compared to those in the control group （P < 0.05）. The PSQI score in the observation group after treatment was lower （P < 0.05） while the scores of physiology and emotion of FACT-G were higher compared to those in the control group （P < 0.05）. Conclusion Oxycodone-acetaminophen combined with local radiotherapy can down-regulate the levels of serum SP， PGE2 and IL-6， relieve the pain， and improve the sleep quality and quality of life in elderly patients with malignant tumor bone metastasis complicated with cancer pain.

Key words: malignant tumor, bone metastasis, cancer pain, elderly, oxycodone-acetaminophen, radiotherapy, prostaglandinE2, interleukin-6

CLC Number:

R730.6

Minghong SHI,Zhanwei LIU,Yang ZHU,Lili XIA,Gang CHENG,Youguo LU. Influence of oxycodone-acetaminophen combined with local radiotherapy on serum cytokines in elderly patients with malignant tumor bone metastasis complicated with cancer pain[J]. The Journal of Practical Medicine, 2025, 41(11): 1718-1723.

Figures/Tables 7

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References 26

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组别	性别		年龄（x ± s） /（岁）	恶性肿瘤类型				骨转移部位					骨转移癌痛时间（x ± s）/月
组别	男	女	年龄（x ± s） /（岁）	食管癌	肺癌	肝癌	其他	胸椎	盆腔	腰椎	颈椎	其他	骨转移癌痛时间（x ± s）/月
观察组（n = 40）	27	13	68.57 ± 3.69	4	21	3	12	7	8	12	2	11	7.69 ± 1.84
对照组（n = 40）	25	15	69.06 ± 3.43	2	19	3	16	5	8	14	3	10	8.12 ± 2.03
χ² /t值	0.220		0.615	1.338				0.730					0.993
P值	0.639		0.540	0.720				0.947					0.324

组别	疼痛缓解					每天暴发性疼痛发生次数（x ± s）/次
组别	完全缓解	显著缓解	中度缓解	轻度缓解	未缓解	每天暴发性疼痛发生次数（x ± s）/次
观察组（n = 40）	10（25.00）	13（32.50）	13（32.50）	3（7.50）	1（2.50）	0.59 ± 0.18
对照组（n = 40）	6（15.00）	11（22.50）	10（25.00）	8（20.00）	5（12.50）	0.77 ± 0.24
Z/t值	2.020					3.795
P值	0.043					< 0.001

组别	SP/（pmol/L）		PGE2/（ng/L）		IL-6/（ng/mL）
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组（n = 40）	569.81 ± 74.15	375.67 ± 53.42^?	254.63 ± 44.77	150.14 ± 32.90^?	83.58 ± 14.49	43.32 ± 8.73^?
对照组（n = 40）	580.21 ± 80.47	429.73 ± 62.95^?	248.15 ± 50.26	187.29 ± 40.38^?	80.74 ± 16.01	51.96 ± 10.50^?
t值	0.601	4.142	0.609	4.511	0.832	4.002
P值	0.550	< 0.001	0.544	< 0.001	0.408	< 0.001

组别	病理性骨折	高钙血症	脊髓压迫	合计
观察组（n = 40）	1（2.50）	2（5.00）	2（5.00）	5（12.50）
对照组（n = 40）	2（5.00）	2（5.00）	2（5.00）	6（15.00）
χ²值				0.105
P值				0.745

组别	恶心	呕吐	便秘	呼吸抑制	皮疹	合计
观察组（n = 40）	3（7.50）	1（2.50）	2（5.00）	0（0.00）	1（2.50）	7（17.50）
对照组（n = 40）	5（12.50）	3（7.50）	3（7.50）	2（5.000）	2（5.00）	15（37.50）
χ²值						4.013
P值						0.045

Influence of oxycodone-acetaminophen combined with local radiotherapy on serum cytokines in elderly patients with malignant tumor bone metastasis complicated with cancer pain

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组别	治疗前	治疗后
观察组（n = 40）	14.62 ± 2.16	8.79 ± 1.25^?
对照组（n = 40）	15.03 ± 2.04	9.94 ± 1.53^?
t值	0.873	3.681
P值	0.386	< 0.001

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组别	生理		情感		社会/家庭		功能
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组（n = 40）	8.54 ± 2.17	13.19 ± 2.63^?	9.26 ± 2.45	13.32 ± 2.31^?	8.82 ± 2.09	9.76 ± 2.14	9.37 ± 2.25	10.24 ± 2.18
对照组（n = 40）	8.33 ± 2.06	11.76 ± 2.41^?	9.05 ± 2.33	11.85 ± 2.26^?	9.01 ± 2.18	9.57 ± 2.22	9.14 ± 2.09	9.95 ± 2.13
t值	0.444	2.535	0.393	2.877	0.398	0.390	0.474	0.602
P值	0.658	0.013	0.696	0.005	0.692	0.698	0.637	0.549