End-stage
cancer patients frequently receive continuous
morphine infusion (CMI) to alleviate the various symptoms associated with
cancer progression or adverse events; however, there have been a limited number of studies concerning such patients. We conducted a retrospective analysis of 79 end-stage
lung cancer patients who received CMI at the Kyoto University Hospital, Kyoto, Japan between 2008 and 2010. Thirty-one patients (39%) received CMI intravenously and 48 (61%) received it subcutaneously. The patients were divided into four groups based on the indications for CMI: group A (uncontrolled
pain; n=9), group B (
dyspnea; n=44), group C (both
dyspnea and
pain; n=13) and group D (an inability to take
oral medicine; n=13). The median maximum dose of
morphine in groups A-D was 60.0, 25.0, 50.0 and 15.0 mg/day, respectively. The median survival time from the start of CMI was 4 days (range 0-136). In our limited experience,
pain,
dyspnea and the inability to take
oral medicine were identified as indications for CMI in end-stage
lung cancer patients, with
dyspnea being the major indication for CMI. Patients in group B (
dyspnea) required a lower dose of
morphine for alleviation compared with those in groups A (uncontrolled
pain) and C (both
dyspnea and
pain). The survival time from the initiation of CMI was markedly shorter in patients with
dyspnea (groups B and C) than in patients without
dyspnea (group A). Further studies are required to facilitate the effective and appropriate use of CMI in end-stage
lung cancer patients.
Dyspnea was the major indication for CMI in end-stage
lung cancer patients, and the survival time was extensively limited in such patients.