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1
題名:THE EFFECT AND SAFETY OF TRANSDERMAL FENTANYL FOR CONCURRENT CHEMORADIATION THERAPY-INDUCED MUCOSITIS PAIN IN HEAD AND NECK CANCER PATIENTS     (18點)
吩坦尼穿皮貼片劑用於治療頭頸部癌症病人因同步化學放射治療所引起之口腔粘膜炎疼痛其效果及安全性
著者:Shih-Hua Liu(劉士華) ;Yu-Jen Chen(陳裕仁) ;Kou-Hua Chang(張國華) ;Yi-Shing Leu(呂宜興) ;Jehn-Chuan Lee(李振川) ;Ming-Jer Huang(黃明哲) ;Hong-Wen Chen(陳虹汶) ;Yuen-Liang Lai(賴允亮)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:吩坦尼穿皮貼片劑 ; 粘膜炎 ; 頭頸部癌症 ; 同步化學放射治療 ; Transdermal fentanyl ; Mucositis ; Head and neck cancer ; Concurrent chemoradiation therapy (CCRT)
刊名:Therapeutic Radiology and Oncology
頁碼:103-111
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:本研究主要是探討吩坦尼穿皮貼片劑(transdermal fentanyl)於治療頭頸部癌症病人因同 步化學放射治療所引發的嚴重口腔粘膜炎疼痛時,其效果和安全性的評估。 材料與方法:本研究之主要對象為被診斷為頭頸部癌症並以同步化學放射治療的病人。當患者 於治療過程中產生嚴重的口腔黏膜炎疼痛(即numeric rating scale [NRS] _ 7)且無法以非類固 醇抗發炎劑(nonsteroid anti-inflammatory drugs)及類固醇藥膏達到控制時,會給予吩坦尼穿皮 貼片劑25 μg/h 。其後每一個星期會做疼痛強度的評估,如果NRS 仍大於7 分,則再給予吩坦 尼穿皮貼片劑25 μg/h 一片。次外,每星期會根據Common Toxicity Criteria (CTC) Version 2.0 記 錄因吩坦尼穿皮貼片劑造成的副作用。 結果:自2002 年10 月至2003 年3 月期間,共有21 位男性及1 位女性頭頸部癌症並接受同步 化學放射治療之病患被收入至此研究中。平均NRS 在使用吩坦尼穿皮貼片劑一週後由原來的 7.65 ± 0.99(基準值)降至3.9 ± 1.29 。而在第五週時,平均NRS 雖上升到了4.79 ± 1.18 , 但仍有意義的低於基準值(p = 0.003)。達到適當的疼痛控制劑量分別為: 25 μg/h 有15 人, 50 μg/h 有5 人, 100 μg/h 則有1 人。ㄧ位患者因為無法忍受的皮膚疹子及嘔吐而在第二週時停止 使用吩坦尼穿皮貼片劑。其它並沒有發現呼吸抑制、意識改變,或者第三或第四級的腸胃道副 作用。 結論:吩坦尼穿皮貼片劑對於控制頭頸部癌症病人因同步化學放射治療所造成的嚴重口腔粘膜 炎疼痛是有效且安全的。吩坦尼穿皮貼片亦減少了這些吞嚥疼痛或吞嚥困難的病人吞食藥物的 需要性,同時也減少了調整傳統止痛藥物所需的時間。未來需要更大型的臨床隨機研究以再評 估吩坦尼穿皮貼片劑對於口腔粘膜炎疼痛的效價和安全性。
Purpose : This prospective, longitudinal study was to evaluate the efficacy and the safety of using TTS-fentanyl for severe oral mucositis pain induced by concurrent chemoradiotherapy (CCRT) in head and neck cancer (HNC) patients. Materials and Methods : Patients diagnosed as HNC and scheduled for concurrent chemoradiotherapy were eligible for this study. TTS-fentanyl was given with the initial dose of 25 μg/h when severe mucositis pain (numeric rating scale [NRS] _ 7) occurred in spite of nonsteroid anti-inflammatory drugs (NSAID) and topical steroidal ointment use. The pain intensity was assessed every week and if severe pain persisted, another dose of 25 μg/h TTS-fentanyl was given. The adverse effects were recorded every week according to Common Toxicity Criteria (CTC) Version 2.0. Results : From October 2002 to March 2003, 21 male and 1 female receiving CCRT with HNC were recruited to this study. The mean NRS for pain significantly decreased from 7.65 ± 0.99 (baseline) to 3.9 ± 1.29 within the first week. In the fifth week, the NRS raised to 4.79 ± 1.18 but was still lower than the baseline (p = 0.003). The sufficient analgesia was achieved in 15 cases with a dose of 25 μg/h, in 5 cases with a dose of 50 μg/h, and in 1 case with a dose of 100 μg/h. One patient withdrew the TTS-fentanyl due to intolerable skin rash and vomiting in the second week. Besides, no one developed respiratory depression, mental clouding, or grade III/IV gatrointestinal toxicities. Conclusion : TTS-fentanyl is effective and safe in the treatment of mucositis-induced pain which is resistant to NSAID in HNC patients receiving CCRT. TTS-fentanyl also spares the need to swallow pain killers in these patients suffering from odynophagia and/or dysphagia, as well as the time for titration of conventional analgesic drugs. Further larger series with randomized setting is warranted to evaluate the efficacy and safety of TTS-fentanyl for oral mucositis pain.


    

本卷期目次
Therapeutic Radiology and Oncology
XV與EDR2底片之劑量表現與可能的影響參數/ 林佑娟許文林陳逸偉廖明雄陳拓榮
Outcome of Salvage Irradiation for Breast Cancer Patients with Locoregional Recurrence/ Ta-Wei YuJi-An LiangShang-Wen ChenShih-Neng YangFang-Jen Lin
Paraganglioma of Head and Neck Treated with Surgery and Local Radiotherapy: Case Report and Reviews of Literature/ Chia-Chun HuangMu-Tai LiuChu-Ping PiTung-Hao Chang
Gingival Metastasis from Rectal Cancer: A Case Report/ Ming-Yii HuangHung-Hong ShyrShi-Long LianKun-Bow TsaiChih-Jen HuangYu-Hue Ho
Evaluation of Two Types of Digitizers for Film Dosimetry/ Chung-Hung TsaiKeh-Shih ChuangShu-Hui HsuChung-Hsien HsuHung-Chi TaiKwan-Hwa Chi
Localized Three Dimensional Conformal Hyperfractionated Radiotherapy in Glioblastoma Multiforme Patients-CGH Experience/ Ching-Jung WuJing-Shan HuangPei-Chieh YuSu-Zun Shaw
探討頭頸部癌合併頸部淋巴結腫大的病患使用二次IMRT治療計劃之必要性/ 郭于誠吳東和黃光偉王雅玲鍾道生蘇文川陳東河邱仲峰
The Effect and Safety of Transdermal Fentanyl for Concurrent Chemoradiation Therapy-Induced Mucositis Pain in Head and Neck Cancer Patients/ Shih-Hua LiuYu-Jen ChenKou-Hua ChangYi-Shing LeuJehn-Chuan LeeMing-Jer HuangHong-Wen ChenYuen-Liang Lai
Experiences of Radiotherapy on Extrapulmonary Small Cell Carcinoma/ Wei-Ting HsuehWu-Chou SuFen-Fen ChenHelen H. W. Chen
THE EFFECT AND SAFETY OF TRANSDERMAL FENTANYL FOR CONCURRENT CHEMORADIATION THERAPY-INDUCED MUCOSITIS PAIN IN HEAD AND NECK CANCER PATIENTS/ Shih-Hua LiuYu-Jen ChenKou-Hua ChangYi-Shing LeuJehn-Chuan LeeMing-Jer HuangHong-Wen ChenYuen-Liang Lai
探討頭頸部癌合併頸部淋巴結腫大的病患使用二次IMRT治療計劃之必要性/ 郭于誠吳東和黃光偉王雅玲鍾道生蘇文川陳東河邱仲峰
LOCALIZED THREE DIMENSIONAL CONFORMAL HYPERFRACTIONATED RADIOTHERAPY IN GLIOBLASTOMA MULTIFORME PATIENTS-CGH EXPERIENCE/ Ching-Jung WuJing-Shan HuangPei-Chieh YuSu-Zun Shaw
XV與EDR2底片之劑量表現與可能的影響參數/ 林佑娟許文林陳逸偉廖明雄陳拓榮
EVALUATION OF TWO TYPES OF DIGITIZERS FOR FILM DOSIMETRY/ Chung-Hung TsaiKeh-Shih ChuangShu-Hui HsuChung-Hsien HsuHung-Chi TaiKwan-Hwa Chi
PARAGANGLIOMA OF HEAD AND NECK TREATED WITH SURGERY AND LOCAL RADIOTHERAPY: CASE REPORT AND REVIEWS OF LITERATURE/ Chia-Chun HuangMu-Tai LiuChu-Ping PiTung-Hao Chang
GINGIVAL METASTASIS FROM RECTAL CANCER: A CASE REPORT/ Ming-Yii HuangHung-Hong ShyrShi-Long LianKun-Bow TsaiChih-Jen HuangYu-Hue Ho
OUTCOME OF SALVAGE IRRADIATION FOR BREAST CANCER PATIENTS WITH LOCOREGIONAL RECURRENCE/ Ta-Wei YuJi-An LiangShang-Wen ChenShih-Neng YangFang-Jen Lin
EXPERIENCES OF RADIOTHERAPY ON EXTRAPULMONARY SMALL CELL CARCINOMA/ Wei-Ting HsuehWu-Chou SuFen-Fen ChenHelen H. W. Chen
 
   
 
   

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