Radiotherapy plus either transdermal fentanyl or paracetamol and codeine for painful bone metastases: a randomised study of pain relief and quality of life.

Abstract

OBJECTIVE:

To compare the effects of providing analgesia with either transdermal fentanyl (TTS-fentanyl) or paracetamol and codeine (P/C) in addition to radiotherapy in patients with metastatic bone pain.

METHODS:

In a prospective study, 26 patients with radiologically confirmed bony metastases received radiotherapy (R/T). They were randomised to receive either 500 mg paracetamol and 30 mg codeine four times per day (P/C group), or transdermal fentanyl patches delivering 25 microg fentanyl/h (TTS-fentanyl group). Pain was assessed using visual analogue pain ratings (VAS) and the Greek Brief Pain Inventory (G-BPI) questionnaire administered before R/T and after 3 months.

RESULTS:

Data were available from 24 eligible patients. Use of TTS-fentanyl was associated with significantly superior pain relief. Mean VAS fell from 7.0 to 1.1 with TTS-fentanyl and from 8.3 to 4.3 with P/C, p< 0.01. The TTS-fentanyl group also showed significantly greater improvements of important G-BPI domains including global quality of life, pain, and physical, cognitive, and role functioning, than the P/C group (p< 0.01). Four patients receiving TTS-fentanyl and three receiving P/C reported severe nausea/vomiting.

CONCLUSIONS:

Transdermal fentanyl combined with R/T was more effective in reducing metastatic bone pain and resulted in greater improvements in quality of life than paracetamol and codeine.

• Authors: Kyriaki Pistevou-Gompaki, Vassilis E Kouloulias, Charalambos Varveris, Kyriaki Mystakidou, Grigoris Georgakopoulos, Nikos Eleftheriadis, Nikos Gompakis, John Kouvaris
• Journal: Current medical research and opinion (Curr Med Res Opin) Vol. 20 Issue 2 Pg. 159-63 ( 2004) ISSN: 0300-7995 [Print] England
• PMID: 15006009 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Analgesics
• Acetaminophen
• Fentanyl
• Codeine

Topics

• Acetaminophen (administration & dosage)
• Activities of Daily Living
• Administration, Cutaneous
• Aged
• Aged, 80 and over
• Analgesics (administration & dosage)
• Bone Neoplasms (secondary, therapy)
• Codeine (administration & dosage)
• Combined Modality Therapy
• Drug Therapy, Combination
• Female
• Fentanyl (administration & dosage)
• Humans
• Male
• Middle Aged
• Pain (drug therapy, radiotherapy)
• Prospective Studies
• Quality of Life
• Statistics, Nonparametric