大剂量羟考酮治疗晚期复发性卵巢癌患者神经病理性疼痛的疗效及生存的影响

Efficacy of high-dose oxycodone on neuropathic pain in patients with advanced recurrent ovarian cancer

目的探讨大剂量羟考酮治疗晚期复发性卵巢癌患者神经病理性疼痛(NP)的效果。方法根据治疗方式将95例晚期复发性卵巢癌NP患者分为观察组(n=48)和对照组(n=47)。对照组患者接受常规剂量羟考酮治疗,观察组患者接受大剂量羟考酮治疗。治疗前和治疗1周后,采用自制疼痛积分量表评估两组患者的疼痛情况。治疗1周后,评估两组患者的不良反应发生率和止痛效果。治疗1个月后比较两组患者的生活质量。随访2年,比较两组患者的中位总生存期(OS)。结果治疗1周后,两组患者疼痛范围、分支数量、疼痛触发状况、疼痛持续时间、疼痛发作频次、抽搐症状维度疼痛积分均低于本组治疗前(P﹤0.05),且观察组患者疼痛范围、分支数量、疼痛触发状况、疼痛持续时间、疼痛发作频次、抽搐症状维度疼痛积分均低于对照组患者(P﹤0.05)。观察组患者镇痛起效时间明显短于对照组患者(P﹤0.01),止痛缓解率优于对照组患者(P﹤0.05)。治疗1个月后,观察组患者生活质量评分明显高于对照组患者(P﹤0.01)。两组患者不良反应发生率和随访2年的中位OS比较,差异均无统计学意义(P﹥0.05)。结论大剂量羟考酮治疗晚期复发性卵巢癌患者的MNP,可有效改善患者疼痛程度,提高生活质量,但不会增加不良反应和缩短生存期。

Objective To investigate the effect of high-dose oxycodone in the treatment of neuropathic pain(NP)in patients with advanced recurrent ovarian cancer.Method A retrospective analysis comprising 95 patients with advanced recurrent ovarian cancer and NP was performed.According to different treatment methods,these patients were allocated as study group(n=48)and control group(n=47),respectively.The control group was treated with conventional doses of oxycodone,while the study group was administered with high-dose oxycodone.Before and 1 week after the treatment,the pain of the two groups was assessed by the self-made pain score scale.After one week of treatment,the incidence of adverse reactions and analgesic effects were evaluated in the two groups.After one month of treatment,the quality of life(QOL)of the two groups of patients was compared.The median overall survival(OS)was compared between the two groups after a 2-year follow-up.Result In one week after treatment,the pain scores,including scope of pain,number of branches,triggering of pain,duration of pain,frequency of pain,and the symptoms of convulsions were lower than those in the group before treatment(P<0.05),and the pain scores of each subscale in study group were lower than those of the control group(P<0.05).The time to onset of analgesia in study group was significantly shorter than that in the control group(P<0.01),and the relief rate of pain was also better in study group than in control group(P<0.05).In one month after treatment,the QOL score of patients in the study group was significantly improved compared to control group(P<0.01).There was no significant difference between the two groups in regard to the incidence of adverse reactions and the median OS of 2-year follow-up(P>0.05).Conclusion High-dose oxycodone,as the treatment of NP among patients with advanced recurrent ovarian cancer,can effectively improve the pain and thus ameliorate quality of life for these patients,without increasing the adverse reactions or shortening the survival time.