缓解性放射治疗和阿片类药物处方模式之间的关系在转移性癌症患者中
Prudvi Raju Arabandi1, Alexander N Slade2, Elena V Fernandez1
1Virginia Commonwealth University, Richmond, VA, USA.
Annals of palliative medicine
|October 20, 2023
概括
息性放射治疗没有降低转移性癌症患者的阿片类药物剂量. 治疗后阿片类药物使用增加,特别是在年轻患者和抑郁症患者中,突出显示了持续的疼痛管理挑战.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 疼痛管理 疼痛管理
背景情况:
- 众所周知,息性放射治疗,特别是对于骨转移,可以改善疼痛的定性测量.
- 息性放射治疗对转移性癌症患者阿片类药物处方模式的定量影响仍未得到充分研究.
研究的目的:
- 在转移性癌症患者中调查息性放射治疗和阿片类药物处方模式之间的关联.
主要方法:
- 回溯分析了182名转移性癌症患者的处方数据,这些患者接受了门诊息性放射治疗.
- 在放射治疗前和后 (30,60,90天) 的平均口服吗啡毫克相当剂量 (MME) 的计算.
- 普通最小平方 (OLS) 回归模型用于识别与中小企业变化相关的因素.
主要成果:
- 放射治疗后阿片类药物剂量显著增加 (平均MME:16.8毫克在90天的放射治疗前和82.4毫克在放射治疗后,P<0.01).
- 年龄较小和并发性抑郁症是放射治疗后MME增加的预测因素.
- 多变量分析证实了这些关联.
结论:
- 转移性癌症患者经历了大量和不断增加的阿片类药物负担,即使是在息性放射治疗后.
- 年轻的患者和抑郁症患者在放射治疗后面临着更高的阿片类药物需求升级的风险.
- 这强调了除了放射治疗之外,需要全面的疼痛管理策略.
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