美沙酮在癌痛患者中的临床应用进展

Progress in Clinical Application of Methadone in Cancer Pain Patients

阿片类是中重度癌痛患者的主要治疗药物,美沙酮是阿片类药物之一。美沙酮与其他阿片类药物相比具有价格便宜、口服生物利用度高、对神经病理性疼痛效果好等优势,但也存在QT间期延长、药动学个体差异大的问题。尽管研究已经证实美沙酮和其他阿片类在癌痛治疗中的安全性类似,但临床医生对美沙酮在癌痛治疗中的认识不足和使用经验欠缺仍然极大的限制了其在癌痛治疗中的应用。本文旨在通过美沙酮在癌症患者中临床应用综述,帮助临床医生更好的了解和应用美沙酮。

Opioids are the main treatment drugs for the patients with moderate and severe cancer pain, and methadone is one of opioid drugs. Compared with the other opioids, methadone has the advantages of low cost, high oral bioavailability and better effect on neuropathic pain. However, methadone also shows such disadvantages as prolonged QT interval and large individual variance in pharmacokinetics. Although the safety of methadone has no difference from the other opioids in the treatment of cancer pain, the lack of knowledge and experience still limits its clinical application. This article aimed to summarize the clinical application of methadone in cancer patients, so as to help clinicians understand and apply methadone better.