Morphine-Methadone Opioid Rotation in Cancer Patients: Analysis of Dose Ratio Predicting Factors

183 Background: Recent studies have reported that methadone has antineoplastic activity. Other studies have associated methadone with lower overall survival in patients with chronic pain. Methadone is the most frequent opioid chosen for purpose of opioid rotation (OR) in cancer patients experiencing refractory pain or opioid induced neurotoxicity. There is no data available on the association of methadone with overall survival in cancer patients. Our aim was to compare the characteristics and overall survival in cancer patients in methadone group with other strong opioid group. Methods: In this ad hoc analysis, we reviewed 2471 consecutive patient visits to the supportive care center of a tertiary cancer center in 2008 for ORs from strong opioids to methadone or other strong opioids with a follow-up visit within 6 weeks. Information regarding demographics, Edmonton Symptom Assessment Scale (ESAS), and morphine equivalent daily dose (MEDD) were collected. Successful pain response was defined as 2-point or 30% reduction in pain score. Kaplan-Meier curves were used to evaluate survival. Results: Of the 102 eligible patients, 54 underwent OR to methadone and 48 to other strong opioids. The median age was 56 years, 56% were male, and 81% had advanced cancer. There were no significant differences between the methadone group and the other opioid group in patient characteristics, performance status, MEDD, and ESAS scores. Although both the groups showed significant pain response, methadone group (72%) had a significantly higher pain response as compared to the other opioid group (65%; P = 0.04). The Kaplan-Meier curves revealed no significant difference in overall survival (OS) between the methadone group and the other opioid group [median OS: 5.2 months (95% CI 3.64-7.41) vs. 5.9 months (95% CI 2.6-9.2); P = 0.89]. Conclusions: We observed no significant difference in overall survival in cancer patients in methadone group as compared to other opioids. Further validation studies in a larger sample are warranted.

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Overall Survival among Cancer Patients Undergoing Opioid Rotation to Methadone Compared to Other Opioids

Journal of Palliative Medicine ◽

10.1089/jpm.2016.0316 ◽

2017 ◽

Vol 20 (6) ◽

pp. 656-661 ◽

Cited By ~ 13

Author(s):

Akhila Reddy ◽

Ulrich S. Schuler ◽

Maxine de la Cruz ◽

Sriram Yennurajalingam ◽

Jimin Wu ◽

...

Keyword(s):

Overall Survival ◽

Cancer Patients ◽

Opioid Rotation

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Factors Associated With Survival After Opioid Rotation in Cancer Patients Presenting to an Outpatient Supportive Care Center

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2013.08.010 ◽

2014 ◽

Vol 48 (1) ◽

pp. 92-98 ◽

Cited By ~ 8

Author(s):

Akhila Reddy ◽

Sriram Yennurajalingam ◽

Maxine de la Cruz ◽

Shana L. Palla ◽

Xuan Wang ◽

...

Keyword(s):

Supportive Care ◽

Cancer Patients ◽

Care Center ◽

Opioid Rotation ◽

Factors Associated ◽

Outpatient Supportive Care

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Financial Distress and its Predicting Factors among Iranian Cancer Patients

Asian Pacific Journal of Cancer Prevention ◽

10.7314/apjcp.2015.16.4.1621 ◽

2015 ◽

Vol 16 (4) ◽

pp. 1621-1625 ◽

Cited By ~ 8

Author(s):

Abazar Fathollahzade ◽

Azad Rahmani ◽

Abbas Dadashzadeh ◽

Akram Gahramanian ◽

Ali Esfahani ◽

...

Keyword(s):

Cancer Patients ◽

Financial Distress ◽

Predicting Factors

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Unmet supportive care needs and determinants among cancer patients treated at University of Gondar Specialized Hospital, Northwest Ethiopia: A prospective cross-sectional study

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155220971035 ◽

2020 ◽

pp. 107815522097103

Author(s):

Begashaw Melaku Gebresillassie ◽

Asnakew Achaw Ayele ◽

Tadesse Melaku Abegaz

Keyword(s):

Supportive Care ◽

Cancer Patients ◽

Unmet Needs ◽

Unmet Need ◽

Cross Sectional Study ◽

Supportive Care Needs ◽

Care Needs ◽

Cross Sectional ◽

Predicting Factors ◽

Specialized Hospital

Background Assessment of supportive care needs is an important requirement to plan supportive care intervention. This study aimed to assess the unmet supportive care needs of cancer patients treated at the University of Gondar Specialized Hospital, Ethiopia. Methods A prospective cross-sectional study was conducted from January 1, 2017 to August 30, 2017. Adult (18 years and greater) cancer patients and those who were receiving therapy were included. The 34-Item short-form Supportive Care Needs Survey(SCNS-SF34) tool was used to assess unmet needs. The data collected were analyzed using SPSS version-21. Results A total of 150 interview guides were included in the analysis (97.4% of response rate). In the majority of 65(43.3%) the participants, the disease was metastasized even though they have undergone surgery 78 (52%). The overall mean score level of unmet need for cancer care was 3.49. The highest unmet need mean score was reported from the health system and information need domain. A significant unmet need difference concerning different need domain was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors for unmet supportive care needs. Conclusion The overall level of unmet need was high. A significant unmet need difference was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors. Hence, professionals working in the oncology unit should be aware of unmet needs and expect changes over time. Certain programs and services to address the identified unmet needs should be urgently provided.

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