Analysis On Influencing Factors Of The Analgesic Effects In Patients With Moderate Or Severe Chronic Cancer Pain

Objective: The overall aim of the present study was to analyze the influencing factorsof the analgesic effects in patients with moderate or severe chronic cancer pain, andprovide some references to clinical analgesic decision-making.Methods: Data from clinical characteristics of353inpatients with moderate orsevere chronic cancer pain in Department of Oncology, The Norman Bethune1stHospital of Jilin University, in January1st,2012to April30th,2013, was analyzed.All the patients were given of standard analgesic treatment. Pain intensity NRS≤3,breakthrough pain≤3times/day, salvage treatment number≤3times/day were usedas the indicators of good pain control. Pain control after7days’ treatment, the timeneeded for good pain control, analgesic doses needed for good pain control werechoosed as the evaluation indicators of analgesic complexity. Propable influencingfactors of analgesic effects consisted of patients’ factors, including gender and age;disease factors, such as type of tumor, TNM staging, having bone metastases or not;pain factors, such as pain intensity, location, causes, mechanism, breakthrough painand its frequency. Logistic regression was used to analyze the correlations betweenthe above factors and pain control after7days’ treatment, and cox regression wasused to analyze the correlations between the above factors and the time needed forgood pain control, while rank-sum test was used for analysis of the associationsbetween the above factors and analgesic doses needed for good pain control.Results:1．After standard analgesic treatment for7days,84.4%of the patients withmoderate or severe chronic cancer pain had good pain control, and analgesictreatment made patients’ KPS improved significantly（P <0.0001）.2．Logistic regression and cox regression analyses showed that digestive systemcarcinoma and severe pain were independent risk factors leading to7days’ poorer pain control and needing longer time for good pain control(P <0.05). The gender, age,TNM staging, pain location, causes, mechanism and bone metastases had norelationship with7days’ pain control and the time needed for good pain control (P>0.05).3. Of241patients who used strong opioids, patients younger than60years old,or those with severe pain, neuropathic pain, frequent breakthrough pain more than3times a day needed more drugs for good pain control (P <0.05). And gender, type oftumor, TNM staging, pain causes, pain location, bone metastases had nothing to dowith the analgesic doses (P>0.05).Conclusions:1．After standard analgesic treatment,84.4%of the patients with moderate orsevere chronic cancer pain had good pain control in7days, and analgesic treatmentsignificantly improved patients’ KPS.2．The factors that might lead to poor pain control in patients with moderate orsevere chronic cancer pain included younger than60years old, the type of digestivesystem carcinoma, severe pain, neuropathic pain, frequent breakthrough pain morethan3times a day.