突破性癌症疼痛的范围审查:绘制证据景观的地图
Mellar Davis1, Russell Portenoy2, Andrew Davies3
1Department of Supportive Oncology, Levine Cancer Institute, Charlotte, NC, USA. Mellar.Davis@advocatehealth.org.
概括
癌症患者的突破性疼痛 (BTP) 缺乏一致的定义和管理策略. 本综述强调了BTP研究中的显著异质性,确定了未来研究和改善患者护理的关键差距.
科学领域:
- 在瘤学瘤学.
- 疼痛管理 疼痛管理
- 证据综合 证据综合
背景情况:
- 癌症患者的突破性疼痛 (BTP) 定义不佳,评估和管理方法各不相同.
- 现有的文献提供了一个异质的证据基础,用于理解和治疗BTP.
- 识别知识差距对于推进BTP管理策略至关重要.
研究的目的:
- 绘制癌症群体中突破性疼痛 (BTP) 的现有证据.
- 描述BTP的概念化,评估和药理管理.
- 确定当前BTP研究领域的关键知识缺口.
主要方法:
- 根据JBI方法和PRISMA-ScR指导方针进行全面的范围审查.
- 在多个数据库 (PubMed,Embase,Scopus等) 进行了搜索. 对于量化研究 (1991-2025年).
- 数据的叙述综合,按时代,定义,人口和干预类型分层.
主要成果:
- 包括146项研究,揭示了BTP操作定义 (强度,阿片类药物使用,持续时间) 的大量异质性.
- BTP的特征 (发病,持续时间,频率) 和流行率估计 (33-95%) 差异很大.
- 临床试验主要使用丰富的招生,专注于短期结果,并由行业赞助,来自不同环境的数据有限.
结论:
- 突破性疼痛 (BTP) 的证据基础以不一致的定义,选定的人口和地理度为特征.
- 关键的知识缺口包括标准化定义,以患者为中心的结果,长期数据,多样化的人口证据和综合方法.
- 未来的指导需要专家的共识,通过务实研究解决差距,以加强BTP管理.
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