Comparative study of long and short opioid titration in the treatment of moderate and severe cancer pain

CHEN Guiming; FU Yanwen; PENG Bing; CAI Peng; ZHU Jiang; WEN Jinming; ZHAO Bolin; LI Chao

doi:10.3969/j.issn.1009-0460.2017.11.013

Abstract：Objective To explore the efficacy and adverse reactions of oxycodone hydrochloride prolonged-release tablets and immediate-release morphine tablets of two different titration schemes in the treatment of moderate and severe cancer pain.Methods One hundred and twenty-three patients with moderate and severe cancer pain were randomly divided into long-acting group (oxycodone hydrochloride prolonged-release tablets,10-20 mg of inital dose,q 12 h) and short-acting group (oral morphine tablets,10 mg of inital dose,q4 h).The pain relief rate and total remission rate in 24,48 and 72 h were evaluated by numerical rating scale(NRS) in two groups.SF-36 scale was used to assess the quality of life.The frequency of additional administration and the incidence of adverse reactions were calculated.Results The complete remission rate of 24,48,72 h in the long-acting group were 53.2％,75.8％ and 83.9％,respectively,which were higher than 34.4％,41.0％ and 68.9％ of the short-acting group (P＜0.05).The total remission of 48 h in the long-acting group was 95.2％,which was higher than 83.6％ in the short-acting group,and the difference was statistically significant(P＜0.05).The proportion of patients who completed the titration in 1 cycle in the long-acting group was 58.1％,which was higher than 34.4％ in the short-acting group,and the difference was statistically significant (P＜0.05).Compared the short-acting group,number of extra administration was significantly reduced in long-acting group.The incidence of constipation in the long-acting group was 45.2％,which was equivalent to 52.5％ of the short-acting group.The incidence of nausea and vomiting in the long-acting group was 30.7％,which was lower than 52.5％ in the short-acting group (P＜0.05).The quality of life in the long-acting group was better than that in the short-acting group.Conclusion The total response rates of oxycodone hydrochloride prolonged-release tablets with immediate-release morphine tablets at 72 h were equivalent,but oxycodone hydrochloride can better control the pain in the short term,improve the patients quality of life,and reduce the workload of medical staff,worthy of clinical popularization and application.