Lucas Zanetti de Albuquerque1, Jesse Lopes da Silva2, Alexssandra Lima Siqueira Dos Santos2, Isabella Pereira Rodrigues2, Andreia Cristina de Melo2. 1. Division of Clinical Research and Technological Development, Brazilian National Cancer Institute (INCA), 37 André Cavalcanti Street, 5th floor, Annex Building, Downtown, Rio de Janeiro, RJ, ZIP Code 20231-050, Brazil. lucas_zanetti1996@hotmail.com. 2. Division of Clinical Research and Technological Development, Brazilian National Cancer Institute (INCA), 37 André Cavalcanti Street, 5th floor, Annex Building, Downtown, Rio de Janeiro, RJ, ZIP Code 20231-050, Brazil.
Abstract
PURPOSE: This study aimed to describe the clinical and demographic profile of cervical cancer patients exploring risk factors for prolonged use of opioids. METHODS: The database of the Brazilian National Cancer Institute was queried out and 214 women with cervical cancer diagnosed between January 2014 and December 2015 who underwent isolated external beam radiation therapy (EBRT) or chemoradiotherapy (CRT) with complete response were included. Patients who no longer used opioids 6 months after completion of radiation therapy were classified as stoppers; patients who continued using opioids were non-stoppers. Variables were comparatively evaluated as risk factors for prolonged use of opioids. RESULTS: The median age was 49.4 years. Most women were non-white (64.5%) and had ECOG Performance Status (PS) ≥ 1 (76.6%), International Federation of Gynecology and Obstetrics (FIGO) stage II-III (84.1%), and squamous cell carcinoma (82.7%). Smoking and alcohol consumption rates were, respectively, 44.9% and 39.7%. The median time from diagnosis to the onset of EBRT was 111 days (interquartile range 66.2). Most patients underwent CRT (88.8%). The rate of non-stoppers was 65.0%. By multivariate analysis, prescription of strong opioids (p = 0.005) and disease recurrence (p < 0.001) were suggested as independent factors for prolonged use of opioids. CONCLUSION: The rate of prolonged use of opioids after radiotherapy is alarming. Prescription of strong opioids and disease recurrence might be independent risk factors for its persistent use. IMPLICATIONS FOR CANCER SURVIVORS: These results reveal an unmet and urgent need to implement public multiprofessional support programs with well-established protocols for dependence withdrawal, as well as stricter national measures of control in opioid prescription.
PURPOSE: This study aimed to describe the clinical and demographic profile of cervical cancer patients exploring risk factors for prolonged use of opioids. METHODS: The database of the Brazilian National Cancer Institute was queried out and 214 women with cervical cancer diagnosed between January 2014 and December 2015 who underwent isolated external beam radiation therapy (EBRT) or chemoradiotherapy (CRT) with complete response were included. Patients who no longer used opioids 6 months after completion of radiation therapy were classified as stoppers; patients who continued using opioids were non-stoppers. Variables were comparatively evaluated as risk factors for prolonged use of opioids. RESULTS: The median age was 49.4 years. Most women were non-white (64.5%) and had ECOG Performance Status (PS) ≥ 1 (76.6%), International Federation of Gynecology and Obstetrics (FIGO) stage II-III (84.1%), and squamous cell carcinoma (82.7%). Smoking and alcohol consumption rates were, respectively, 44.9% and 39.7%. The median time from diagnosis to the onset of EBRT was 111 days (interquartile range 66.2). Most patients underwent CRT (88.8%). The rate of non-stoppers was 65.0%. By multivariate analysis, prescription of strong opioids (p = 0.005) and disease recurrence (p < 0.001) were suggested as independent factors for prolonged use of opioids. CONCLUSION: The rate of prolonged use of opioids after radiotherapy is alarming. Prescription of strong opioids and disease recurrence might be independent risk factors for its persistent use. IMPLICATIONS FOR CANCER SURVIVORS: These results reveal an unmet and urgent need to implement public multiprofessional support programs with well-established protocols for dependence withdrawal, as well as stricter national measures of control in opioid prescription.
Authors: Joseph Friedman; David Kim; Todd Schneberk; Philippe Bourgois; Michael Shin; Aaron Celious; David L Schriger Journal: JAMA Intern Med Date: 2019-04-01 Impact factor: 21.873
Authors: Nathan P Coussens; G Sitta Sittampalam; Samantha G Jonson; Matthew D Hall; Heather E Gorby; Amir P Tamiz; Owen B McManus; Christian C Felder; Kurt Rasmussen Journal: J Pharmacol Exp Ther Date: 2019-09-03 Impact factor: 4.030
Authors: Paul A Glare; Pamela S Davies; Esmé Finlay; Amitabh Gulati; Dawn Lemanne; Natalie Moryl; Kevin C Oeffinger; Judith A Paice; Michael D Stubblefield; Karen L Syrjala Journal: J Clin Oncol Date: 2014-05-05 Impact factor: 44.544