PMID- 8874346
OWN - NLM
STAT- MEDLINE
DCOM- 19961112
LR  - 20170210
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 14
IP  - 10
DP  - 1996 Oct
TI  - Clinical experience with oral methadone administration in the treatment of pain 
      in 196 advanced cancer patients.
PG  - 2836-42
AB  - PURPOSE: The aims of this study were to describe the analgesia, side effects, and 
      dosage and the causes of suspension of treatment in a large sample of advanced 
      cancer patients with pain after treatment with oral methadone from 7 to 90 days. 
      PATIENTS AND METHODS: In a retrospective study, data collected for 196 advanced 
      cancer outpatients with moderate to severe pain treated at 8-hour intervals with 
      oral methadone in solution form from February 1993 to February 1995 were analyzed 
      at baseline (time 0) and then at 7, 15, 30, 45, 60, and 90 days. The following 
      parameters were assessed: Karnofsky Performance Status, intensity of pain (using 
      the Integrated Pain Score [IPS], intensity of pain, insomnia, drowsiness, 
      confusion, dry mouth, nausea, vomiting, constipation, and dyspnea (using the 
      Therapy Impact Questionnaire [TIQ], mean daily dose of drug administered, and 
      reasons for withdrawal from study. The period when pain was reduced by > or = 35% 
      with respect to baseline was evaluated with the Palliation Index. The association 
      of the degree of palliation of pain with the age of the patients, tumor site, 
      analgesic treatment taken at baseline, and daily mean dose of methadone 
      administered during the follow-up period was analyzed by means of the 
      Kruskal-Wallis test. RESULTS: A reduction in pain intensity with respect to 
      baseline occurred at each analysis time, and in 55.1% of the patients the 
      reduction during the follow-up period was > or = 35% according to the Palliation 
      Index. The mean dose of oral methadone ranged from 14 mg at day 7 to 23.65 mg at 
      day 90. There was an overall worsening of the other symptoms, but a high 
      percentage of the patients reported an amelioration of insomnia with respect to 
      baseline. There was a statistically significant association (P < .0001) between 
      the Palliation Index and the analgesic therapy administered at baseline. Only 
      11.2% of the patients withdrew from the study due to analgesic inefficacy and 
      6.6% due to methadone-related side effects (10 patients with drowsiness and three 
      with severe constipation. CONCLUSION: Oral methadone administered every 8 hours 
      was shown to be an appropriate analgesic therapy in the treatment of advanced 
      cancer-related pain. The worsening of the other symptoms under study can be 
      considered linked to the progression of the disease, and in fact, only a small 
      percentage of the patients reported methadone-related side effects that warranted 
      suspension of treatment. We consider oral methadone to be a useful analgesic 
      therapy, and it should be considered in clinical practice for the treatment of 
      cancer pain.
FAU - De Conno, F
AU  - De Conno F
AD  - Division of Pain Therapy, National Cancer Institute, Milano, Italy.
FAU - Groff, L
AU  - Groff L
FAU - Brunelli, C
AU  - Brunelli C
FAU - Zecca, E
AU  - Zecca E
FAU - Ventafridda, V
AU  - Ventafridda V
FAU - Ripamonti, C
AU  - Ripamonti C
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 0 (Analgesics, Opioid)
RN  - UC6VBE7V1Z (Methadone)
SB  - IM
MH  - Administration, Oral
MH  - Aged
MH  - Analgesics, Opioid/*therapeutic use
MH  - Female
MH  - Humans
MH  - Male
MH  - Methadone/*therapeutic use
MH  - Middle Aged
MH  - Neoplasms/*complications
MH  - Pain/etiology/*prevention & control
MH  - Retrospective Studies
EDAT- 1996/10/01 00:00
MHDA- 1996/10/01 00:01
CRDT- 1996/10/01 00:00
PHST- 1996/10/01 00:00 [pubmed]
PHST- 1996/10/01 00:01 [medline]
PHST- 1996/10/01 00:00 [entrez]
AID - 10.1200/JCO.1996.14.10.2836 [doi]
PST - ppublish
SO  - J Clin Oncol. 1996 Oct;14(10):2836-42. doi: 10.1200/JCO.1996.14.10.2836.