Efficacy of controlled-release oxycodone for reducing pain due to oral mucositis in nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy: a prospective clinical trial
Efficacy of controlled-release oxycodone for reducing pain due to oral mucositis in nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy: a prospective clinical trial
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控释羟考酮减轻同步放化疗鼻咽癌患者口腔粘膜炎疼痛的功效：一项前瞻性临床试验
DOI：
10.1007/s00520-019-4643-5
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发表时间：
2019-10-01
影响因子：
3.1
通讯作者：
Guo, Ling
中科院分区：
文献类型：
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作者：
Hua, Xin;Chen, Lin-Min;Guo, Ling
口腔粘膜炎（OM）引起的疼痛是鼻咽癌（NPC）患者同步放化疗（CCRT）中的一个主要问题。根据疼痛程度分为中度疼痛组（n= 27）和重度疼痛组（n= 29（中度=数字评定量表（NRS）评分4-6或重度= NRS评分7-10）。结果重度疼痛患者的CRO总剂量显著高于中度疼痛患者（791.60 ± 332.449 mg与587.27 ± 194.940 mg;P= 0.015）。中度疼痛患者的生活质量明显更好（P= 0.037），体重减轻更少（P= 0.030），CCRT反应更积极（90.9% vs. 64.0%;P= 0.041）。虽然两组的24小时疼痛控制率相当（85.2% vs. 86.2%;P= 0.508），中度疼痛组评分最终稳定在~ 2分，重度疼痛组为3分（P< 0.001）;中度疼痛患者达到持续疼痛（NRS ≤ 3）的滴定时间也明显缩短（2.45 ± 0.60天vs 3.60 ± 1.98天;P= 0.012）。不良事件的发生率在两个groups.ConclusionsThe研究结果表明，早期引入低剂量的CRO在中度疼痛阶段，可以帮助减少所需的总剂量，提供更好的疼痛控制，提高生活质量，并提高CCRT反应。
BackgroundPain due to oral mucositis (OM) is a major problem during concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) patients.MethodsWe enrolled 56 NPC patients receiving CCRT and allocated them into two groups: moderate pain group (n= 27) and a severe pain group (n= 29) according to the degree of pain reported (moderate = numerical rating scale (NRS) score 4–6 or severe = NRS score 7–10) at initiation of controlled-release oxycodone (CRO) treatment.ResultsTotal dose of CRO was significantly higher in severe pain patients than in moderate pain patients (791.60 ± 332.449 mg vs. 587.27 ± 194.940 mg;P= 0.015). Moderate pain patients had significantly better quality of life (P= 0.037), lower weight loss (P= 0.030) and more active CCRT response (90.9% vs. 64.0%;P= 0.041). Although 24-h pain control rate was comparable in the two groups (85.2% vs. 86.2%;P= 0.508), the moderate pain group score eventually stabilized at ~ 2 vs. 3 in the severe pain group (P< 0.001); the titration time to reach bearable pain (NRS ≤ 3) was also significantly shorter in moderate pain patients (2.45 ± 0.60 days vs. 3.60 ± 1.98 days;P= 0.012). Incidence of adverse events was comparable in both groups.ConclusionsThe study findings suggest that early introduction of low-dose CRO at the moderate pain stage could help reduce the total dose required, provide better pain control, improve quality of life, and enhance CCRT response.