Abstract | PURPOSE: METHODS: We included 104 consecutive advanced cancer patients who were extensively pretreated with opioids. They were rotated to parenteral hydromorphone because they failed to achieve adequate pain relief on other opioids. Pain intensity and side effects were daily assessed. The moment of adequate pain control was defined as the first of at least 2 consecutive days when the mean pain intensity at rest was ≤ 4 (on a 0-10 numeric rating scale) and side effects were tolerable. RESULTS: The reasons for rotation to parenteral hydromorphone were inadequate pain control with/without expected delivery problems due to high opioid dosages (n = 61) and intolerable side effects with persistent pain (n = 43). Adequate pain control was achieved in 86 patients (83%) within a mean of 5 days. Eight of 86 patients still had side effects, but these were scored as acceptable. The mean pain intensity at rest decreased from 5.4 [standard deviation (sd) = 2.1] to 2.4 (sd = 1.5; p < 0.001). The median failure-free treatment period was 57 days and covered a substantial part of the median survival of 78 days in the responding patients. CONCLUSIONS:
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Authors | Wendy H Oldenmenger, Paul J Lieverse, Paul J J M Janssen, Walter Taal, Carin C D van der Rijt, Agnes Jager |
Journal | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
(Support Care Cancer)
Vol. 20
Issue 8
Pg. 1639-47
(Aug 2012)
ISSN: 1433-7339 [Electronic] Germany |
PMID | 21861200
(Publication Type: Journal Article)
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Chemical References |
- Analgesics, Opioid
- Hydromorphone
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Topics |
- Analgesics, Opioid
(administration & dosage)
- Female
- Humans
- Hydromorphone
(administration & dosage)
- Infusions, Parenteral
- Male
- Middle Aged
- Neoplasms
(complications)
- Pain Management
(methods)
- Pain Measurement
- Pain, Intractable
(drug therapy, etiology)
- Retrospective Studies
- Treatment Failure
- Treatment Outcome
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