Methadone switching for refractory cancer pain

doi:10.1186/s12904-022-01076-2

	Methadone switching for refractory cancer pain
	Ding, Haiying 3; Song, Yu 3; Xin, Wenxiu 3; Sun, Jiao 2,3; Zhong, Like 2,3; Zhou, Qinfei 1; He, Chaoneng 3; Gong, Liyan 1; Fang, Luo 2,3
刊名	BMC PALLIATIVE CARE
	2022-11-02
卷号	21
关键词	Methadone Refractory cancer pain Efficacy Safety Cost Opioids switching
ISSN号	1472-684X
DOI	10.1186/s12904-022-01076-2
通讯作者	Gong, Liyan(1413472557@qq.com) ; Fang, Luo(fangluo@zjcc.org.cn)
英文摘要	Background Methadone is commonly considered an alternative opioid treatment for refractory cancer pain. This study aims to investigate the efficacy, safety, and cost of methadone in the treatment of refractory cancer pain. Methods A retrospective study was conducted in patients who used methadone for refractory cancer pain from April 2016 to December 2020 at a cancer specialized hospital. Pain control, evaluated via pain score and breakthrough pain frequency, and adverse events of methadone were compared with analgesic regimens prior to methadone administration. The factors potentially affecting the switching outcome were analyzed via multivariate analysis. Moreover, the cost of pain control was estimated. Results Ninety patients received methadone for poor pain control (74.4%), intolerable adverse events (10.0%), or both (15.6%) after prior opioid treatments. Sixty-four patients (71.1%) were successfully switched to methadone with median pain score significantly decreased from 4.0 to 2.0 (p < 0.001) and median daily frequency of breakthrough pain from 3.0 to 0.0 (p < 0.001) at a maintained median conversion ratio of 6.3 [interquartile range (IQR): 4.0-10.0] to prior opioid treatment. Similar adverse event profiles of constipation, nausea, vomiting, and dizziness were observed between methadone and prior opioid regimens. The median daily cost of analgesic regimens was significantly reduced from $19.5 (IQR: 12.3-46.2) to $10.8 (IQR: 7.1-18.7) (p < 0.01) after switching to methadone. The 3-day switch method significantly improved the rate of successful switching compared with the stop and go method (odds ratio = 3.37, 95% CI: 1.30-8.76, p = 0.013). Conclusion Methadone is an effective, safe, and cost-saving treatment for patients with refractory cancer pain.
资助项目	Natural Science Foundation of Zhejiang Province[LQ19H280001] ; Projects of Medical and Health Technology Program in Zhejiang Province[2018KY312] ; Projects of Medical and Health Technology Program in Zhejiang Province[2019KY037]
WOS关键词	MANAGEMENT ; MORPHINE ; ROTATION ; ANALGESICS ; PREVALENCE ; EFFICACY ; SAFETY
WOS研究方向	Health Care Sciences & Services
语种	英语
出版者	BMC
WOS记录号	WOS:000878123500003
资助机构	Natural Science Foundation of Zhejiang Province ; Projects of Medical and Health Technology Program in Zhejiang Province
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/130049]
专题	中国科学院合肥物质科学研究院
通讯作者	Gong, Liyan; Fang, Luo
作者单位	1.Chinese Acad Sci, Univ Chinese Acad Sci, Zhejiang Canc Hosp,Dept Rare Canc & Head & Neck M, Inst Basic Med & Canc IBMC,Canc Hosp, Hangzhou, Peoples R China 2.Zhejiang Canc Hosp, Zhejiang Key Lab Prevent Diag & Therapy Upper Gas, Hangzhou 310022, Peoples R China 3.Chinese Acad Sci, Univ Chinese Acad Sci, Zhejiang Canc Hosp, Inst Basic Med & Canc IBMC,Dept Pharm,Canc Hosp, Hangzhou, Peoples R China
推荐引用方式 GB/T 7714	Ding, Haiying,Song, Yu,Xin, Wenxiu,et al. Methadone switching for refractory cancer pain[J]. BMC PALLIATIVE CARE,2022,21.
APA	Ding, Haiying.,Song, Yu.,Xin, Wenxiu.,Sun, Jiao.,Zhong, Like.,...&Fang, Luo.(2022).Methadone switching for refractory cancer pain.BMC PALLIATIVE CARE,21.
MLA	Ding, Haiying,et al."Methadone switching for refractory cancer pain".BMC PALLIATIVE CARE 21(2022).