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JPainPalliatCarePharmacother.2006;20(4):33-9.

Highdosecontrolled-release oxycodonein hospicecare.

BercovitchM1,AdunskyA.

Authorinformation

  • 1TelHashomerHospiceatTheChaimShebaMedicalCenter,TelHashomer,Israel.

Abstract

Controlled-releaseoxycodone(OxyContin)iscommonlyusedforpainreliefinterminalcancer.Thisopioidmaybeconsideredasatreatmentoptionforpatientswhopreferoralpaincontrol,butwhoareunwillingtotakeoralmorphinesulphateorcannottolerateitssideeffects.However,littleisdocumentedabouttheuseofhighdosesofthisdruginterminalcancerpatients.ThepurposeofthisstudywastoinvestigatetheclinicalcharacteristicsofterminallyillhospiceinpatientstreatedwithOxyContinforpain,andtocomparethosepatientsreceivinghigh-doseOxyContin(150mg/day)withpatientstakinglowandmoretypicaldoses.Thisretrospectivechartanalysiswithparallelgroupsincludedrecordsof97consecutiveterminalcancerpatients.Werecordedclinicalanddemographicdata,aswellasdataregardingdailydoses,rescuedosesandparametersassociatedwithqualityoflife.ThemeandailyOxyContindosewas78.6 mgperdayforallpatients.Only18(18.55%)patientsweretreatedwithhighdoses(meandailydose

231.1mg).Nostatisticallysignificantcorrelationswerefoundbetweenanyofthedeomographicparametersanddoseranges,withtheexceptionofpatientswithpainfulbonymetastaseswhoconsumedsignificantlyhigherdoses(p=0.008).NodifferenceswereobservedinsleepqualityormoodasafactorofOxyContindoses.However,comparedwithpatientsreceivinglow-dose(OR1.0),patientstreatedwithmoderateandhighdosesmaintainedKarnofskyscoreshigherthan40pointsmostofthetime(OR= 3.77,CI1.1-13.0andOR4.95,CI0.8-29.9,respectively).SurvivalwasnotrelatedtoOxyContindoses(LogRanktest,p=0.12;Breslowtest,p=0.37).WeconcludethattheuseofhighdoseOxyContinforterminalcancerpainmanagementissafe,efficient,andunrelatedtoshortersurvivaltimes.TheresultssuggestthathealthcareprofessionalsmayusehigherOxyContindoses,whenindicated,toenablebetterpainreliefandqualityend-of-lifecare.

PMID:

17182504

[PubMed-indexedforMEDLINE]

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