OBJECTIVE MEASURES/GASTROINTESTINAL MORBIDITY REDUCTION

胃肠道症状，如腹胀、恶心和 呕吐通常发生在晚期癌症人群中，并且 这是一个主要的发病率来源。现在，人们认识到这些情况正在发生。 即使在病程的早期，在疾病发生之前， 化疗用药。几项初步研究已经 提示这些症状可能与一种特定的 病理生理缺陷，胃排空延迟。在建议的 研究表明，胃肠道症状的量化指标将是 决心促进对未来癌症控制的识别 这一领域的干预措施。不能切除的男性患者50例 癌(非小细胞癌、下咽癌和前列腺癌) 没有接受过化疗，目前没有接受麻醉性止痛 或者止吐药物将进行为期三天的住院评估。临床 主诉腹胀、恶心或呕吐将是 以及一个扩展的量化尺度来评估这些 症状。卡路里摄入量的基线测定， 人体测量学和外周血液中的β-内啡肽水平 已执行。然后，患者将随机接受一次静脉注射 安慰剂、β-内啡肽或硫酸吗啡 连续几天后对固体胃进行定量 排空、饱腹感、疼痛、代谢变量(葡萄糖、胰岛素和 高血糖素)和食物消费。合并症状的患者 意志3分或以上的腹胀、恶心和呕吐的评分 然后每天服用甲氧氯普胺，反复住院 治疗四周后进行评估。因此， 本组患者胃排空定量异常的发生率 人口将被决定，并与饱足、痛苦、 代谢变量和膳食摄入量(量和卡路里 密度)。此外，β-内啡肽、β-内啡肽、 硫酸吗啡、甲氧氯普胺、胃排空等 将探索研究参数。总而言之，这是 信息将允许开发理性的和潜在的 改进干预策略以减少胃肠道症状 不能切除的癌症患者的发病率。

Gastrointestinal symptoms such as abdominal fullness, nausea and vomiting commonly occur in the advanced cancer population and are a source of major morbidity. These are now recognized to occur even early in the course of disease, prior to, and independent of, chemotherapy administration. Several preliminary studies have suggested such symptoms may be related to a specific pathophysiologic defect, delayed gastric emptying. In the proposed study, quantitative measures of gastrointestinal symptoms will be determined to facilitate identification of future cancer control interventions in this area. Fifty male patients with unresectable carcinoma (non-small cell of the, dropharyngeal, and prostate) with no prior chemotherapy, not currently receiving narcotic analgesia or antiemetics will have three-day inpatient evaluations. Clinical complaints of abdominal fullness, nausea or vomiting will be elicited along with an expanded quantitative scale assessing these symptoms. Baseline determination of caloric intake, anthropometrics and peripheral blood betaendorphin levels will be performed. Patients will then randomly receive one I.V. injection of either placebo, beta-endendorphin or morphine sulphate on 3 consecutive days followed by quantitation of solid gastric emptying, satiety, pain, metabolic variables (glucose, insulin and glucagon) and food consumption. Patients with a combined symptom score for abdominal fullness, nausea and vomiting of 3 or more will then be given daily metoclopramide and undergo repeat inpatient evaluation after four weeks of therapy. As a result, the prevalence of quantitive abnormalities in gastric emptying in this population will be determined and correlated with satiety, pain, metabolic variables and dietary intake (amount and caloric density). In addition, the relationships among beta endorphin, morphine sulphate, metoclopramide, gastric emptying, and other study parameters will be explored. Taken together, this information will permit development of rational and potentially improved intervention strategies to reduce gastrointestinal morbidity in patients with unresectable cancer.