Durogesic treatment of advanced cancer pain and quality of life analysis of the clinical efficacy
Author: Zou Bing Xin, Huang Zuo-ping, XIE
Qiang, Zhao Dang, Wang Kan
【Abstract】 Objective To investigate the Durogesic and MS
Contin treatment of moderate to severe cancer pain, the efficacy and quality of life. Methods 126 patients with moderate to severe cancer pain were randomly divided into two groups, were treated Durogesic (A group) and MS Contin (B) treatment, and record its efficacy, side effects and quality of life. Results Durogesic with MS Contin for pain relief rates were 88.89%, 87.30%, pain relief and quality of life was no significant difference (P> 0.05). Transdermal fentanyl group, nausea, constipation, the incidence of side effects was lower than MS Contin (P <0.01). Conclusion Durogesic the treatment of moderate to severe cancer pain of the safe, reliable, side effects of drugs.
Key words Durogesic; MS Contin; cancer pain
The Analysis of Clinic Effects and Quality of Life in the Treatment for Moderate to Sever Cancer Pain
The Third Department of Internal Medicine, Guangdong Provincial Corp Hospital of Chinese Peoples Armed Police Force, Guangzhou 510507, ChinaAbstract: Objective To
investigate the efficacy, side effects and quality of life between transdermal fentanyl plaster (Durogesic) and sustained release morphine tablet (MS Contin) in the treatment for
moderate to sever cancer pain. Methods 126 patients were randomized into Durogesic group (group A) and MS Contin
group (group B). The two groups received Durogesic and MS
contin respectively. Then the efficacy, side effects and quality of life were recorded. Results The difference of the effective rates and quality of life of Durogesic and MS
Contin were not significant. However, the incidence of vomit and constipation were significantly higher in the MS Contin
group than that of in the Durogesic group. Conclusion The Durogesic is a drug that is safe, reliable and has little side
effect in treating moderate to sever cancer pain.
Key words: Durogesic; MS Contin; Cancer pain
From April 2004 our hospital has 126 patients with advanced cancer pain patients were randomly divided into two groups in order to Durogesic (transdermal fentanyl system), scientific name: Fentanyl Transdermal System (Xi'an Janssen Pharmaceutical Co., Ltd. production) outside the paste (A group) and MS Contin oral (B) treatment, now its analgesic effect and adverse reaction reports are as follows:
1 Data and methods
1.1 Case Selection
126 cases of patients with selected undergraduate, male 75 cases, female 51 cases. All these proved to be malignant by pathology, and accompanied by moderate and severe pain. 47
patients with moderate pain, severe pain in 79 cases. Of these, 43 cases of lung cancer, 7 cases of gastric cancer, liver in 47 cases, 11 cases of esophageal cancer, pancreatic cancer, 3 cases of gallbladder carcinoma, 2 cases of colon cancer in 13 cases. Patients were randomly divided into A group and B group, A group of age (64.5 ? 9.1) years, 53
cases were male and 20 female; B group (61.9 ? 8.7) years, 46
cases were male and female 17 cases. No difference between the two groups of information.
A group of multi-Rigi externally bonded, multi-drug Regis
principles: (1) untreated doses to determine: past without the use of too strong opioids in patients with moderate pain in patients given 2.5 mg (the release of fentanyl per hour 25μg)
began to moderate or severe pain and began to give 5mg; used strong opioids in patients, dose conversion formula [Durogesic an hour to release the dose (μg) = daily oral morphine dose
(mg) × 1 / 2] conversion. Transdermal fentanyl in the paste,
while the last use of controlled-release morphine (fentanyl
slow onset); or the use Durogesic the first 12h, to continue the original amount of morphine that is released, foil every 3 days to replace a sub - . (2) Multi-Regis Usage: Durogesic
paste parts of the trunk or upper arm should be hair-free,
flat area, clean and dry skin (can not use soap, oils, or detergents) will affect its absorption of drugs. (3) The paste will make sure that medical membrane formation, a little push, full contact with the skin, the replacement patch, the
attention to changing positions, and to avoid the accumulation of fentanyl. Replaced once every 3 days, while adjusting doses to keep patients pain-free or almost painless to 24h were
observed for 15 days for a course of treatment. B group were
given oral administration of MS Contin, initially given oral MS Contin 30mg/12h, can not be completely pain, the oral administration of MS Contin to increase the amount of 60mg/12h. Adjust the dose so that patients achieve pain-free
or basic painless 24h were observed for 15 days as a course of treatment.
1.3 Clinical evaluation
1.3.1 pain intensity rating
Split method using visual analogue (VAS): 1 ~ 3 for mild pain; 4 to 6 as moderate pain; 7 to 10 was severe pain.
1.3.2 determine the effect of
In the 15 days of pain medication to alleviate
Evaluation: 0 degrees, the pain did not ease; ?, pain relieve
1 / 4; ?, pain relieve 1 / 2; ?, pain relieve 3 / 4; ?,
pain disappear. Pain relief pain relief rate refers to the
grade ? or the ratio of the total cases. Reposted elsewhere in the paper for free download http://
1.3.3 Adverse reactions to determine
Determined according to WHO standards.
1.3.4 Evaluation of functional status
According to QLQ C30 scoring to rate .
1.4 Statistical analysis
To compare the efficacy and toxicity of the rank sum test u test the quality of life comparison (points) with ? s said
that all the data analysis in statistical software on
2.1 A group of analgesic efficacy of
Complete remission in 14 cases, 30 cases of apparent ease, moderate ease in 12 cases, mild to ease in 4 cases, non-
remission in 3 cases, with a total effective rate was 88.89%.
The analgesic efficacy of B group: 12 cases of complete remission significantly ease the 33 cases, 10 patients with moderate ease, mild easing in 5 cases, non-remission in 3
cases, efficiency of 87.30%. As the sample more, so using u test (u = 0.0266, P = 0.8705). Two groups the difference was not statistically significant.
2.2 A, B groups before and after treatment compared quality of life
Table 1. Table 1 A, B groups after treatment to assess, quantitatively measure the quality of life comparison
2.3 Observation of adverse reaction
Table 2. Table 2 A, B two treatment programs for cancer pain in patients with toxic side effect (omitted)
Pain is a common symptoms of cancer, good analgesia can
not only improve the quality of life of patients, but also to improve treatment compliance.
Transdermal fentanyl is currently the only opioid used in transdermal agents, the main component of citrate. Fentanyl
and morphine, the same as the M receptor agonist, analgesic effect of morphine in 75 ~ 100 times its molecular weight is small, fat-soluble good and irritation for transdermal delivery, the initial drug 6 ~ 12 hours reach peak plasma
concentrations of 12 to 24 hours up to a stable blood concentration, the replacement once every 72 hours, the same dose of drugs, we can maintain a stable blood concentration, Persoli Gudelj M et al  that the administration is more convenient 24-hour continuous intravenous administration of non-means .
Durogesic medication is part of the skin surface, drug absorption from the digestive tract pH, and food, drugs in the intestines move, moving time and other complex factors, to avoid the drug in the liver first-pass effect. Particularly
suitable for gastrointestinal symptoms are more difficult for patients with oral drugs. In the efficacy and side effects, our results and Wang Guangsheng, James Ding, etc. [3,4] report similar to. Radbruch L investigated 994 cases of cancer
patients found that the use of fentanyl skin permeability of fentanyl doses are safe and reliable treatment of cancer pain drug , another study showed that the use of Fentanyl Transdermal Treatment of Pain The inpatient treatment than the
general non-use of fentanyl pain patients discharged from hospital earlier . Although foreign reports of fentanyl can cause cognitive impairment and affect the patient's lung ventilation , but we did not find in the course of these side effects.
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