The Applied Study Of Extended-release Oxycodone As Background Administration In Titration Of Cancer Patients With Moderate To Severe Pain

Background and objective:Pain is one of the most common complications in parients with malignant tumors. Pain control is important in cancer patients.with moderate to severe pain.Opioids are the major analgesics used in cancer pain control.Patients have various levels in pain tolerance.as well as their sensitivity to opioid analgesics.Besides, a individual patient might develop different pain tolerance in each tumor stage. Therefore, it is necessary to perform opiods titration.Oral,subcutaneous and intravenous administration of morphine during titration is the routine method at present. It will take several cycles to finish the titration, which lead to poor compliance for patients and heavy workload for doctors. The extended-release oxycodone consist with immediate-release phase and controlled-release phase.It has been reported that a stable plasma concentration of oxycodone hydrochloride extended-release tablets can be achieved within24hours, which make it easy for titration. This research is to study extended-release oxycodone in titrationin of cancer pain in patients with moderate to severe pain as background administration.Methods:58patients with moderate to severe cancer pain (numeric range scale,NRS>4) were enrolled in the study, including52cases with moderate and6cases with severe pain. Patients need to complete the Brief Pain Inventory(BPI) before enrolled and everytime they suffered a breakthough pain.After given oxycodone hydrochloride extended-release tablets10mg, the pain was assessed1hour later. The immediate-release morphine was given if the pain was not relieved (NRS>3)according to the principles of the The Diagnosis and Treatment Critera of Cancer Pain (CHINA MINISTRY OF HEALTH) NCCN Adult Cancer Pain Guidelines (2010Edition) until pain control. The cycles of titration,the quality of life and the drug safety assessment were recorded after treatment.Results:Totally the pain of48patients’cancer pain of the58patients with cancer pain(82.76%of the total) were well controlled after1cycle of titration,and most of them(97.9%) have.The control rate of pain patients with moderate pain before titration accounted for97.9%. During the first cycle titration.The mean titration cycle number in moderate pain was1.10±0.30,and was2.33±0.82in patients with severe pain.30cases of visceral pain controlled during first cycle titration, which accounts for51.72%, while somatic pain were15cases(25.86%) and mixed pain were13cases(22.42%). It had been a significant improvement in the quality of life such as life style,emotion, walking ability, working ability, relationship and sleeping by BPI scale.The most common adverse events during titration were constipation, nausea and vomiting. None of them withdraw from the study due to side effects.Conclusion:This study suggests that it is a safety, easy and simple way for patients with moderate to severe pain using extended-release oxycodone as background administrarion during titration. It can also improve the quality of life during pain titration.