Oncology
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In order to evaluate the potential role of oxycodone in cancer pain management, neuropathic cancer pain was selected as a model for difficult pain syndromes. A nonsystematic, yet exhaustive, review of the literature provided the relevant evidence for the discussion. Ten randomized controlled trials (RCTs) and 5 open-label studies on oxycodone and cancer pain, 3 RCTs and 1 open-label study on oxycodone and neuropathic pain, and 2 RCTs on oxycodone and visceral pain were identified and reviewed. ⋯ The intrinsic difficulties in performing RCTs in cancer pain have traditionally justified the acceptance of drugs already known to be effective in benign neuropathic pain, in spite of insufficient evidence in malignant neuropathic pain. Therefore, a case is made for the development of specific guidelines for the management of both simple and complex cases of neuropathic cancer pain. An example of one of such clinical guidelines is provided, in which the role of oxycodone is particularly relevant given the existing evidence.
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Multicenter Study Controlled Clinical Trial
Postmarketing surveillance study of OxyContin tablets for relieving moderate to severe cancer pain.
To evaluatethe efficacy and safety of OxyContin tablets (controlled-release oxycodone hydrochloride: 5, 10, 20, and 40 mg) in relieving moderate to severe cancer pain. ⋯ OxyContin tablets demonstrated fast onset of cancer pain control, superior efficacy in relieving both moderate and severe cancer pain and a good safety profile.
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For many patients, neuropathic pain (NeP) is arguably more difficult to control than nociceptive or 'normal' pain. We also now recognise the great burden that NeP has on the lives of patients - it is not only a matter of treating pain in isolation, but managing all of the issues that affect the patient's quality of life. Until relatively recently we have had little understanding of the pathophysiology causing NeP and have relied on the secondary effects of non-analgesic drugs as the mainstays of treatment. ⋯ However, they are now fully established as effective and useful second- or third-line drugs. Many patients in the past have been potentially undertreated as a result of our inertia to use opioids. The case for opioid therapy in NeP has been firmly established.
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This is a multicenter investigational survey conducted in 76 hospitals in Shanghai between July and August 2004. The objective was to investigate the cancer pain status and physicians' pain management capabilities in Shanghai. A total of 923 cancer patients involved in the investigation completed a questionnaire which included general condition, self-assessment of pain and questions of pain control knowledge. The study results were analyzed concerning: reason for cancer pain, type and intensity of cancer pain, treatment methods, patients' understanding of addiction, patients' request for pain treatment, and patients' and physicians' viewpoint on current cancer pain treatment.
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Comparative Study
A treatment selection protocol for recurrent ovarian cancer patients: the role of FDG-PET/CT and staging laparoscopy.
To investigate the best diagnostic and staging strategy for recurrent ovarian cancer. ⋯ The combination of FDG-PET/CT and staging laparoscopy has a significant effect on the multimodal approach to the population of patients with recurrent ovarian cancer. Such techniques should be considered complementary, because of the potential of each one to identify a different setting of the disease.