title: [Standards, options and recommendations for the use of medical analgesics for the treatment of pain arising from excess nociception in adults with cancer (update 2002)].
abstract: BACKGROUND
  The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of french cancer centers (FNCLCC), the 20 French cancer centers, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery.
  
  
  OBJECTIVE
  To develop clinical practice guidelines for the use of medical analgesics for the treatment of pain arising from excess nociception in adults with cancer according to the definitions of the Standards, Options and Recommendations project.
  
  
  METHODS
  In 1996, a working group, set up by the FNCLCC published clinical practice guidelines for pain management in adult and paediatric patients with cancer. In the light of the evolution of our knowledge, and practice these guidelines need to be updated. The section on "medical analgesic treatments" in the document published in 1996 was examined by the working group to identify which questions should be updated. These questions and the relevant key words were used to develop a search strategy which was used to search Medline , and for particular questions, Embase , from January 1994 to March 1999, for relevant references, published in English or French.
  
  
  RESULTS
  For this update, only a few randomised clinical trials were identified, and their conclusions were generally weak. Thus much of the information in this document is based on the World Health Organisation (WHO) guidelines and represents the "state of the art" on this subject in France and is supported by expert agreement. Some changes to the original SOR are presented, eg. methods of titration, prescription of new opioids, opioid rotation. We also present a synthesis of recent pharmacological and regulatory data. The integral version is available on the FNCLCC web site (http://www.fnclcc.fr/sor.htm).
authors.affiliation: FNCLCC, Standards, Options, Recommandations, 101, rue de Tolbiac, 75654 Paris Cedex 13, France.
authors.forename: Ivan
authors.initials: I
authors.lastname: Krakowski
authors.forename: Serge
authors.initials: S
authors.lastname: Theobald
authors.forename: Laurent
authors.initials: L
authors.lastname: Balp
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Bonnefoi
authors.forename: Giselle
authors.initials: G
authors.lastname: Chvetzoff
authors.forename: Olivier
authors.initials: O
authors.lastname: Collard
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Collin
authors.forename: Monique
authors.initials: M
authors.lastname: Couturier
authors.forename: Thierry
authors.initials: T
authors.lastname: Delorme
authors.forename: Roseline
authors.initials: R
authors.lastname: Duclos
authors.forename: Alain
authors.initials: A
authors.lastname: Eschalier
authors.forename: Bernard
authors.initials: B
authors.lastname: Ffergane
authors.forename: Francois
authors.initials: F
authors.lastname: Larue
authors.forename: Marc
authors.initials: M
authors.lastname: Magnet
authors.forename: Christian
authors.initials: C
authors.lastname: Minello
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Navez
authors.forename: Anne
authors.initials: A
authors.lastname: Richard
authors.forename: Bruno
authors.initials: B
authors.lastname: Richard
authors.forename: Sylvie
authors.initials: S
authors.lastname: Rostaing-Rigattieri
authors.forename: Hubert
authors.initials: H
authors.lastname: Rousselot
mesh_terms: D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy*
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid