Abstract:
BACKGROUND:Although adjuvant analgesics are used to treat opioid-refractory cancer pain, there is insufficient evidence to support this practice and limited data to guide the choice depending on cancer pain pathophysiology, dose titration and starting dose. This survey aimed to clarify the current use of adjuvant analgesics for treating opioid-refractory cancer pain. METHODS:In this cross-sectional study, we sent an online survey questionnaire to 208 certified palliative care specialists. Primary outcomes were (i) effective pathophysiological mechanism of cancer pain and (ii) initiating doses and time period to the first response to each adjuvant analgesic therapy. RESULTS:In total, 87 (42%) palliative care specialists responded. Of all patients with cancer pain, 40% of patients (median) with refractory cancer pain were prescribed adjuvant analgesics. Additionally, 94.3, 93.1 and 86.2% of palliative care specialists found dexamethasone/betamethasone effective for neuropathic pain caused by tumor-related spinal cord compression, pregabalin effective for malignant painful radiculopathy and dexamethasone/betamethasone effective for brain tumor or leptomeningeal metastases-related headache, respectively. The median starting dose of pregabalin, dexamethasone/betamethasone, lidocaine and ketamine were 75, 4, 200, and 50 mg/day, respectively, and the median time to the first response of those medications were 5, 3, 2 and 3 days, respectively. CONCLUSIONS:Many palliative care specialists select adjuvant analgesics depending on the pathophysiological mechanism of cancer pain in each case. They used such adjuvant analgesics in low doses for cancer pain with short first-response periods.
journal_name
Jpn J Clin Oncoljournal_title
Japanese journal of clinical oncologyauthors
Tagami K,Matsuoka H,Ariyoshi K,Oyamada S,Hiratsuka Y,Kizawa Y,Koyama A,Inoue Adoi
10.1093/jjco/hyaa147subject
Has Abstractpub_date
2020-12-16 00:00:00pages
1434-1441issue
12eissn
0368-2811issn
1465-3621pii
5899553journal_volume
50pub_type
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journal_title:Japanese journal of clinical oncology
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doi:
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abstract:BACKGROUND:To evaluate pathological complete response rate and to identify the predictor of response after primary systemic chemotherapy (PST) with weekly docetaxel and epirubicin for locally advanced breast cancer. METHODS:Sixty-three patients with locally advanced breast cancer received three cycles PST on day 1 and...
journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,评审
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
doi:
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,评审
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
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更新日期:2017-03-01 00:00:00
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
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journal_title:Japanese journal of clinical oncology
pub_type: 临床试验,杂志文章
doi:10.1093/jjco/29.3.160
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:Although cigarette smoking is considered as an important risk factor for esophageal cancer, the magnitude of the association might be varied among geographic areas. Therefore, we reviewed epidemiologic studies on the association between cigarette smoking and esophageal cancer among the Japanese population. M...
journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,评审
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,评审
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
doi:
更新日期:1991-08-01 00:00:00
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
doi:10.1093/jjco/hys159
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,多中心研究
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
doi:10.1093/jjco/hye040
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,评审
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更新日期:2016-05-01 00:00:00