EFFICIENCY TREATMENT OF CHRONIC PAIN SYNDROME IN CANCER PATIENTS IV CLINICAL GROUP

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Sherbak Anna
Belarusian State Medical University, Minsk, Belarus

EFFICIENCY TREATMENT OF CHRONIC PAIN SYNDROME IN CANCER PATIENTS IV CLINICAL GROUP

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EFFICIENCY TREATMENT OF CHRONIC PAIN SYNDROME IN CANCER PATIENTS IV CLINICAL GROUP

  1. 1. EFFICIENCY TREATMENT OFCHRONIC PAIN SYNDROME INCANCER PATIENTS IVCLINICAL GROUPRapporteur Sherbak AnnaBelarusian State Medical University, Minsk, BelarusSupervisor of PhD Papok V.E.
  2. 2. Aim of work examine the incidence of chronic pain (CPS)depending from the primary tumor site causes of CPS estimate the effectiveness of treatment incancer patients CPS IV clinical group
  3. 3. The urgency of the problem According toWHO statistics, 6 million cases ofcancer, 5.5 million suffer from pain. In Belarus, 40,000 patients with newly diagnosedmalignant process (about 9000 patients inMinsk). Of these, 13.5% is in stage III-IV disease and 25%of patients die within the first year afterdiagnosis. Thus each year nearly 20,000 cancer patientssuffer from pain
  4. 4. Materials and methods(1) The studies were performed in 60 cancerpatients with chronic pain (32 women and 28men) aged 46 - 89 years. All patients were in thehospital Hospital palliative care "Hospice".26, 43%19, 32%15, 25%The age structure of patients61-75 years(advanced age)46-60 years(adulthood)76-89 years(senium)
  5. 5. Materials and methods(2) Hospital record McGill Pain Questionnaire 10-point visual analogue scale (VAS) Verbal pain scale (VPS). Physical activity scale (PAS) Side effects of drugs
  6. 6. The distribution of patientsdepending on the location of theprimary tumor23, 38%10, 17%8, 13%4, 7%4, 7%3, 5%2, 3% 6, 10%Digestive organsBreathing systemMammary glandProstatePancreasOrgans ot theurinary systemCUPOther localization
  7. 7. The distribution of patientsdepending on the type of pain37, 63%14, 24%5, 8% 3, 5%Visceral painSomatic painMixed painNeuropathic pain
  8. 8. The distribution of patientsdepending on the causes of painCause of pain The number ofpatientsThe proportion ofpatients (%)The pain caused bya neoplasticprocess49 82The pain caused bycomplications oftumor8 13The pain is causedby anti-tumortherapy3 5
  9. 9. Patients with CPS associatedwith neoplastic process The pain is associated with a primary tumor - 15 patients(30.6%) The pain associated with metastatic disease - 34 patients(56.6%)11, 32%9, 26%8, 24%3, 9%3, 9%BonesHeparLungsBrainOther localization
  10. 10. Characteristics of patientgroupsA group ofpatientsNumber ofpatientsThe painintensity ontheVASThe natureof pain(VPS)DrugsGroup I 33 3 - 5 ModeratepainKetorolacGroup II 17 5 - 8 Severe pain TramadolGroup III 10 8 - 10 Horrible pain Promedol
  11. 11. The condition of patientsbefore and after treatmentA group ofpatientsVASbeforetreatmentVAS aftertreatment*PAS beforetreatmentPAS aftertreatmentSideeffects(%)Group I(VAS=3 – 5)4,1 ± 0,82 2,3 ± 0,64 2,6 ± 0,49 2,1 ± 0,17 4 (12%)Group II(VAS=5-8)6,2 ± 0,41 2,8 ±0,79 3,4 ± 0,61 2,3 ± 0,96 6 (35 %)Group III(VAS=8-10)8,3 ± 0,46 3,2 ± 1,14 3,6 ± 0,49 2,1 ± 0,61 2 ( 20 %)The changes are significant at p <0,0001
  12. 12. The effectiveness oftreatment in each group CBS31;94%13;76%9;90%2;6%4;23%1;10%0%10%20%30%40%50%60%70%80%90%100%Group I Group II Group IIIEffective therapy no effective therapy
  13. 13. The incidence of sideeffects29;88%11;65%8;80%4;12%6;35%2;20%05101520253035Group I Group II Group IIINo side effects Side effects of
  14. 14. The effectiveness oftramadol The group II of the most high indicators of theinefficiency (4;23%) and the emergence ofside-effects (6;35%) MeanVAS before treatment in this group ofpatients whose treatment was ineffectivewas 6,75 ± 0,43
  15. 15. The results and conclusions (1) CPS in patients with cancer is more common inthe localization of the primary tumor in theorgans of the gastrointestinal tract, therespiratory tract and mammary gland The emergence of CPS in patients with cancer ismore often associated neoplastic processitself, especially with the presence of metastases The most severe pain syndrome seen in patientswith brain metastases and metastatic havinglytic activity in the bone
  16. 16. The results and conclusions (2) The use of ketorolac in patients withmoderate pain and promedol in patients withintolerable pain is an effective The results of use of tramadol in patients withstrong pain differ, so patients with CPS 5-7points on theVAS application is effective, andin patients with a ≥ 7 points CPS is inefficientand requires the use of drugs.
  17. 17. Thank you for your attention!

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