SİBEL ÖZCAN, Sevim AKIN, AYSUN YILDIZ ALTUN, ESEF BOLAT, Selami Ateş ÖNAL

Etkin ağrı tedavisi pankreas kanserli hastalarda sağkalımı artırabilir

Amaç: Bu çalışmada algoloji kliniğine başvuran pankreas kanserli hastaların özellikleri ve analjezik tedavisi değerlendirildi. Gereç ve Yöntem: Algoloji kliniğine başvuran 60 pankreas kanserli hastanın demografik özellikleri, patolojik tanısı ve metastazı, kanser tedavisi ve analjezik müdahaleleri incelendi. Bulgular: Algoloji kliniğine başvuru süresi tanı aldıktan sonra ortalama 3.9±0.92 ay, başvurudaki visual analog skala (VAS) skoru ortalama 6.96±0.11’idi. Analjezik basamak tedavisine göre hastaların %58.33‘de nonopioid+zayıf opioid+kuvvetli opioid (transdermal form), %5’de nonopioid+zayıf opioid+kuvvetli opioid (oral form), %36.66’da nonopioid+zayıf opioid tedavi uygulandı. Hastaların %31.66’a adjuvan eklenmezken %68.33’e adjuvan eklendi (%80.48 benzodiazepin, %19.51 antidepresan). Metastatik pankreas kanserli hastalarda ortalama sağ kalım süresi 3-6 ay arasında değişirken ağrı kliniğine başvuran hastalarda 8.48±7.46 ay olarak tespit edildi. Sonuç: Pankreas kanserinde karın ağrısı hastaların yaşam kalitesini olumsuz etkileyen en yaygın semptomdur. Ağrı sağ kalımı azaltırken iyi bir analjezi ise sağ kalımı iyileştirir. Bu çalışmanın sonuçları, algoloji kliniğinde etkili ağrı tedavisi alan metastatik pankreas kanserli hastaların sağ kalımının daha uzun olabileceğini göstermektedir.

Effective pain therapy can improve the survival of patients with pancreatic cancer

Objectives: In this study, characteristics and analgesic treatment of patients with pancreatic cancer who applied to the algology clinic were evaluated. Methods: Demographic characteristics, pathologic diagnosis, metastasis, cancer treatment, and analgesic interventions in 60 patients with pancreatic cancer, referred to the algology clinic, were examined. Results: The application time of the patients to the clinic was 3.9±0.92 months after the diagnosis, and the visual analog scale (VAS) was 6.96±0.11 at the initial assessment. According to the analgesic step ladder protocol, a nonopiod + weak opioid + strong opioid (transdermal) were applied in 58.33%, a nonopioid + weak opioid + strong opiod (oral) in 5%, and nonopiod + weak opioid in 36.66% of the patients. Adjuvant pain medications were used in 68.33% of the patients (benzodiazepine, 80.48%; antidepressant, 19.51%), while no adjuvant was used in 31.66% of the patients. While the mean survival time for patients with pancreatic cancer changed from 3 to 6 months, it was 8.48±7.46 months for patients who applied to the pain clinic. Conclusion: Abdominal pain in pancreatic cancer is the most common symptom that negatively affects the quality of life. A good analgesia improves the survival, while pain decreases the survival. The results of the present study demonstrated that the survival of the patients with metastatic pancreatic cancer who received effective pain therapy in the algology clinic may be longer.

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