Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients

被引：48

作者：

Mercadante, Sebastiano ^{[1
,2
]}

Marchetti, Paolo ^{[3
]}

Cuomo, Arturo ^{[4
]}

Caraceni, Augusto ^{[5
]}

Mediati, Rocco Domenico ^{[6
]}

Vellucci, Renato ^{[6
]}

Mammucari, Massimo ^{[7
]}

Natoli, Silvia ^{[8
]}

Lazzari, Marzia ^{[8
]}

Dauri, Mario ^{[8
]}

Adile, Claudio ^{[1
,2
]}

Airoldi, Mario ^{[9
]}

Azzarello, Giuseppe ^{[10
]}

Bandera, Mauro ^{[11
]}

Blasi, Livio ^{[12
]}

Carteni, Giacomo ^{[13
]}

Chiurazzi, Bruno ^{[13
]}

Costanzo, Benedetta Veruska Pierpaola ^{[14
]}

Degiovanni, Daniela ^{[15
]}

Fusco, Flavio ^{[16
]}

Guardamagna, Vittorio ^{[17
]}

Iaffaioli, Vincenzo ^{[18
]}

Liguori, Simeone ^{[19
]}

Palermo, Loredana ^{[20
]}

Mameli, Sergio ^{[21
]}

Masedu, Francesco ^{[22
]}

Mattioli, Rodolfo ^{[23
]}

Mazzei, Teresita ^{[24
]}

Melotti, Rita Maria ^{[25
]}

Menardo, Valentino ^{[26
]}

Miotti, Danilo ^{[27
]}

Moroso, Stefano ^{[28
]}

Pascoletti, Gaetano ^{[29
]}

De Santis, Stefano ^{[30
]}

Orsetti, Remo ^{[31
]}

Papa, Alfonso ^{[32
]}

Ricci, Sergio ^{[33
]}

Scelzi, Elvira ^{[34
]}

Sofia, Michele ^{[35
]}

Tonini, Giuseppe ^{[36
]}

Valle, Alessandro ^{[37
]}

Aielli, Federica ^{[38
]}

机构：

[1] La Maddalena, Anesthesia & Intens Care, I-90146 Palermo, Italy

[2] La Maddalena, Pain Relief & Support Care, I-90146 Palermo, Italy

[3] Univ Roma La Sapienza, Mol & Clin Med Med Oncol, I-00155 Rome, Italy

[4] IRCCS Fdn Pascale, Natl Canc Inst, Anesthesiol Resuscitat & Pain Therapy Dept, I-80131 Naples, Italy

[5] IRCCS Fdn, Natl Canc Inst, Palliat Care Pain Therapy & Rehabil, I-20133 Milan, Italy

[6] Careggi Hosp, Palliat Care & Pain Therapy Unit, I-50139 Florence, Italy

[7] ASL RM1, Primary Care Unit, I-00165 Rome, Italy

[8] Univ Roma Tor Vergata, Dept Clin Sci & Translat Med, I-00133 Rome, Italy

[9] Citta Salute & Sci Hosp Turin, Med Oncol Div 2, I-10126 Turin, Italy

[10] ASL 13 Mirano, Med Specialties Dept, Oncol & Oncol Hematol, I-30035 Venice, Italy

[11] Osped Circolo & Fdn Macchi Hosp, Med Oncol Unit, I-21100 Varese, Italy

[12] ARNAS Osped Civ Cristina Benfratelli, Med Oncol Unit, I-90127 Palermo, Italy

[13] AORN Cardarelli, Med Oncol, I-80131 Naples, Italy

[14] SAMO ONLUS, Palliat Care Unit, I-95131 Catania, Italy

[15] ASL AL, Palliat Care Unit, I-15033 Casale Monferrato, Italy

[16] ASL 3 Genovese, Palliat Care Unit, Dept Primary & Community Care, I-16125 Genoa, Italy

[17] IRCCS, European Oncol Inst, Palliat Care & Pain Therapy Unit, I-20141 Milan, Italy

[18] IRCCS Fdn Pascale, Natl Canc Inst, Abdominal Med Oncol, I-80131 Naples, Italy

[19] Papa Giovanni XXIII Hosp, Palliat Care & Pain Therapy Unit, I-24121 Bergamo, Italy

[20] Natl Canc Res Ctr Giovanni Paolo II, Med Oncol Unit, I-70124 Bari, Italy

[21] ASL 8, A Businco Hosp, Pain Therapy Unit, I-09134 Cagliari, Italy

[22] Univ Aquila, Sect Clin Epidemiol & Environm Med, Dept Biotechnol & Appl Clin Sci, I-67100 Laquila, Italy

[23] S Croce Hosp, Med Oncol Unit, I-61032 Fano Pesaro, Italy

[24] Univ Florence, Dept Hlth Sci, Sect Clin Pharmacol & Oncol, I-50139 Florence, Italy

[25] Univ Bologna, Dept Med & Surg Sci, I-40126 Bologna, Italy

[26] S Croce & Carle Hosp, PainTherapy, I-12100 Cuneo, Italy

[27] IRCCS Fdn, Pain Therapy ICS Maugeri, I-27100 Pavia, Italy

[28] Azienda Sanit Univ Integrata Trieste, Med Oncol, I-34128 Trieste, Italy

[29] Azienda Sanit Univ Integrata Udine, Med Oncol, I-33100 Udine, Italy

[30] S Camillo Forlanini Hosp, Palliat Care & Oncol Pain Serv, I-00152 Rome, Italy

[31] S Camillo Forlanini Hosp, Pain Med Unit, I-00152 Rome, Italy

[32] Monaldi Hosp, AO Dei Colli, Pain Relief, I-80131 Naples, Italy

[33] S Chiara Univ Hosp, Dept Oncol, Div Med Oncol, I-56126 Pisa, Italy

[34] Castelfranco Veneto Hosp, Med Oncol, I-31033 Treviso, Italy

[35] G Salvini Hosp, Dept Palliat Care, Hosp & Pain Therapy Unit, I-20024 Milan, Italy

[36] Campus Biomed Univ Rome, Dept Med Oncol, I-00128 Rome, Italy

[37] FARO Fdn, Palliat Care, I-10133 Turin, Italy

[38] Univ Aquila, Dept Biotechnol & Appl Clin Sci, I-67100 Laquila, Italy

来源：

CANCERS | 2018年 / 10卷 / 06期

关键词：

breakthrough pain; cancer; palliative care; supportive care; PREVALENCE; CLASSIFICATION; CARE;

D O I：

10.3390/cancers10060175

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: The aim of this study was to identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP). Methods: Cancer patients with a diagnosis of BTP were enrolled. Demographic and clinical characteristics, as well as background pain and BTP characteristics were collected. Multivariate analyses were conducted to assess the correlation between BTP characteristics and the variables examined. Results: Data of 4016 patients were analysed. Average daily number of BTP episodes was 2.4, mean intensity was 7.5, and a mean duration was 43.3 min. A short onset BTP was observed in 68.9% of patients. In 30.5% of patients BTP was predictable. There were 86.0% of participants who reported a marked interference of BTP with their daily activities. Furthermore, 86.8% of patients were receiving opioids for the management of BTP. The average time to meaningful pain relief was 16.5 min and 70.9% of patients were satisfied with their BTP medications. Age, head and neck cancer, Karnofsky, background pain intensity, predictable and fast onset BTP were independently associated with the number of BTP episodes. BTP pain intensity was independently associated with background pain intensity, fast onset BTP, and Karnofsky. Neuropathic pain mechanism was independently associated with unpredictable BTP. Variables independently associated with a longer duration of BTP were age, place of visit, cancer diagnosis, disease-oriented therapy, background pain intensity and mechanism, and unpredictable BTP. Age, Karnofsky, background pain intensity, fast onset, and long duration of BTP were independently associated with interference with daily activity. Conclusions: BTP has a variable presentation depending on interdependent relationships among its different characteristics.

引用

页数：14

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