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Characteristics and prognostic factors for pain management in 152 patients with lung cancer

机译：152例肺癌患者疼痛治疗的特点和预后因素

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Objective: The objective of this study was to analyze the pain characteristics and factors influencing the outcome of pain control in patients with lung cancer having pain. Methods : Pain characteristics, the effectiveness, and prognostic factors for pain control were analyzed in 152 patients with lung cancer having moderate or severe chronic pain admitted to Cancer Center of The First Hospital of Jilin University, People’s Republic of China, between January 2012 and May 2013. Information about sex, age, pathological type, TNM stage, presence/absence of bone metastases, characteristics of pain, methods, and effectiveness of pain management was recorded. Results : Patients with non-small-cell lung cancer and small-cell carcinoma accounted for 132/152 (86.8%) and 20/152 (13.2%) cases, respectively. Among them, moderate (72.4%) or severe pain (27.6%) was reported in 73.7% of the cases at stage IV, chest or back pain was reported in 76.3% of the cases, and pain in other locations in the rest of the cases. Bone metastases were apparent in 44.1% of the patients. Neuropathic pain was noted in 46.7% of the patients, and frequent breakthrough pain was noted in 25.7% of the patients. High pain intensity was associated with frequent breakthrough pain. Pain was adequately controlled in 81.6% of the patients prescribed 3?days of analgesics. More patients reported a KPS higher than or equal to 80 after 3 days of analgesic treatment ( P <0.001). Severe pain, frequent breakthrough pain, and presence of bone metastases were independent risk factors for poor pain control. Severe pain, frequent breakthrough pain, or neuropathic pain in the patients using opioids required higher doses of analgesic for pain control. Opioids plus nonsteroidal anti-inflammatory drugs offered better pain control than opioids alone. Conclusion: High pain intensity is associated with frequent breakthrough pain in patients with lung cancer, which can be largely controlled with analgesics. Severe pain, frequent breakthrough pain, presence of bone metastases, and neuropathic pain are predictors of refractory pain.
机译：目的：本研究的目的是分析患有肺癌的肺癌患者的疼痛特征和影响疼痛控制结果的因素。方法：分析2012年1月至5月在中国吉林大学第一医院癌症中心收治的152例中度或重度慢性疼痛肺癌患者的疼痛特征，疗效和预后因素。 2013年。记录了有关性别，年龄，病理类型，TNM分期，是否存在骨转移，疼痛特征，方法和疼痛治疗效果的信息。结果：非小细胞肺癌和小细胞癌分别占132/152（86.8％）和20/152（13.2％）病例。其中，IV期73.7％的病例报告为中度疼痛（72.4％）或重度疼痛（27.6％），76.3％的患者报告为胸痛或背痛，其余部分则为其他部位的疼痛案件。 44.1％的患者可见骨转移。在46.7％的患者中发现了神经性疼痛，在25.7％的患者中发现了频繁的突破性疼痛。高疼痛强度与频繁的突破性疼痛有关。处方使用3天镇痛药的患者中有81.6％的患者疼痛得到了适当控制。止痛治疗3天后，有更多患者报告KPS高于或等于80（P <0.001）。剧烈疼痛，频繁突破性疼痛和骨转移的存在是疼痛控制不佳的独立危险因素。使用阿片类药物的患者的剧烈疼痛，频繁突破性疼痛或神经性疼痛需要更高剂量的镇痛药以控制疼痛。阿片类药物加上非甾体类抗炎药比单独使用阿片类药物能更好地控制疼痛。结论：高疼痛强度与肺癌患者频繁的突破性疼痛相关，可以通过止痛药来控制。严重疼痛，频繁突破性疼痛，骨转移的存在和神经性疼痛是难治性疼痛的预示因素。

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