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， 一个主要的发病率的来源。 现在人们认识到， 甚至在疾病过程的早期，在此之前，并且独立于， 化疗给药。 一些初步研究表明， 这表明这些症状可能与一种特定的 病理生理缺陷胃排空延迟 拟议 研究，胃肠道症状的定量措施将是 决心促进确定未来的癌症控制 在这方面的干预。 50例男性患者， 癌（非小细胞癌、喉咽癌和前列腺癌）伴 既往无化疗，目前未接受麻醉镇痛 或止吐药都要进行为期三天的住院评估 临床 腹部饱胀，恶心或呕吐的投诉将 引出沿着一个扩大的量化尺度评估这些 症状 热量摄入的基线测定， 人体测量和外周血β内啡肽水平将 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，然后定量胃固体 排空、饱腹感、疼痛、代谢变量（葡萄糖、胰岛素和 胰高血糖素）和食物消耗。 合并症状的患者 腹胀、恶心和呕吐评分为3分或3分以上 然后每天服用甲氧氯普胺并重复住院 治疗四周后进行评估。 结果导致 胃排空定量异常的患病率 将确定群体并将其与饱腹感，疼痛， 代谢变量和饮食摄入量（量和热量 密度）。 此外，β内啡肽， 硫酸吗啡、胃复安、胃排空和其他 将探索研究参数。 总的来说，这 信息将有助于制定合理的和潜在的 改善干预策略，以减少胃肠道 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.