Effect of dose escalation with single opioid, fentanyl matrix in patients not controlling cancer pain: a multicenter, prospective, observational study in Korea.
OBJECTIVE
End-of-dose failure (EOD) is a clinically common observation and many cancer patients increase the frequency of opioid administration. Fentanyl matrix use is known to be effective in patients with chronic cancer pain. To measure the effectiveness of increase in a single dose of fentanyl matrix in patients whose pain was not controlled sufficiently, we perform this study.


METHODS
A multi-center, open-label, prospective, observational study was conducted in 30 hospitals in Korea, between August and December 2008.


RESULTS
A total of 452 patients were enrolled; 404 patients completed the study. The mean pain intensity decreased from 5.27 at the first visit to 3.37 at the end of the trial. There was a significant difference in pain intensity (p < 0.001) between the first and last visits. The percentage of pain intensity difference was 30.1%. The prevalence of EOD at the first visit was 73% from the 452 enrolled patients. After the use of fentanyl patch, EOD decreased from 73% to 56%. Pain intensity of patients experiencing EOD was 5.64 at the baseline compared to 4.27 in patients without EOD. On final visit, pain intensity in patients with and without EOD was 4.02 and 2.54, respectively. The observed adverse events were mainly nausea, asthenia, constipation and diarrhea.


CONCLUSIONS
This study demonstrated that increasing dose of fentanyl patch decreased pain intensity and decreased the rate of patients experiencing EOD. Thus, fentanyl patch may be an effective modality in cancer patients whose pain was previously not controlled sufficiently; the side effects were as could be expected with an opioid.
Department of Hematology-Oncology, Yeungnam University College of Medicine, Daegu, Korea.
Sung Ae
SA
Koh
Department of Hematology-Oncology, Yeungnam University College of Medicine, Daegu, Korea.
Kyung Hee
KH
Lee
Department of Hematology-Oncology, Yeungnam University College of Medicine, Daegu, Korea.
Mi Jung
MJ
Kim
Department of Hematology-Oncology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Kyu Taek
KT
Lee
Department of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Seung Woo
SW
Park
Department of Hematology-Oncology, VHS Medical Center, Seoul, Korea.
Seung Hyun
SH
Nam
Department of Hematology-Oncology, Daegu Catholic University Medical Center, Daegu, Korea.
Hun Mo
HM
Ryoo
Fentanyl; Neoplasms; Pain