ABSTRACT
Opioids are the main treatment drugs for the patients with moderate and severe cancer pain,and methadone is one of opioid drugs. Compared with the other opioids, methadone has the advantages of low cost, high oral bioavailability and better effect on neuropathic pain. However, methadone also shows such disadvantages as prolonged QT interval and large individual variance in pharmacokinetics. Although the safety of methadone has no difference from the other opioids in the treatment of cancer pain,the lack of knowledge and experience still limits its clinical application. This article aimed to summarize the clinical application of methadone in cancer patients,so as to help clinicians understand and apply methadone better.
ABSTRACT
OBJECTIVE:To explore the effects of angiotensin converting enzyme inhibitors (ACEI)/angiotensin Ⅱ receptor blockers (ARB) on the prognosis in patients with advanced gastric cancer complicated with hypertension.METHODS:By retrospective study,clinical information of histologically confnrned Ⅲ-Ⅳ stage advanced gastric cancer patients with hypertension receiving 2 cycles of first-line chemotherapy plan containing fluorouracil at least were collected from Zhejiang Tumor Hospital during Jan.1st,2009-Dec.31th,2012.The data were summarized and analyzed.The patients receiving ACEI/ARB drugs were included in trial group,and the patients receiving other antihypertensive drugs were included in control group.Telephone follow-up was conducted in 2 groups.RESULTS:A total of 124 patients meeting the inclusion criteria were enrolled in this study.There was no statistical significance in age,gender,smoking history,ECOG score,family history of disease,family history of tumor,TNM staging,pathological type,tumor site or chemotherapy plan between trial group (23 cases) and control group (101 cases),except for history of alcohol intake (P＞0.05).Total response rate of first-line chemotherapy was 73.9％ in trial group,which was significantly higher than 41.6％ of control group,with statistical significance (P＜0.05).There was no statistical significance in 1-year or 3-year survival rate between 2 groups (P＞0.05).Median survival time of trial group was 669 d,which was significantly longer than 410 d of control group,with statistical significance (P＜0.05).Results of COX regression analysis showed that therapeutic efficacy of first-line chemotherapy influenced the survival of patients in different antihypertensive agent groups (P＜0.05).CONCLUSIONS:Compared with other antihypertensive drugs,ACEI/ARB agents significantly improve response rate of first-line chemotherapy in patients with advanced gastric cancer complicated with hypertension,significantly prolong median survival time,but have no significant effect on survival rate;at the same time,statistical comparison of definite drinking amount are absent.It needs to be further confirmed by multi-center,prospective and large-scale sample.
ABSTRACT
Objective: To investigate the utilization status of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in 11 hospitals of Zhejiang province from 2009 to 2015, and to analyze the use rationality.Methods: The doctor's advice in 40 days annually was collected in 11 hospitals of Zhejiang province from 2009 to 2015, and the drug consumption, frequency of utilization (DDDs), defined daily cost (DDC) and drug utilization index (DUI) were analyzed for the patients with lung cancer treated with EGFR-TKI.Results: Icotinib, erlotinib and gefitinib were the three prevalent EGFR-TKIs used in Zhejiang province, and icotinib started to be used in clinics in 2013.The overall cost of EGFR-TKIs increased year by year during 2009 and 2015, and the total amount of sales increased by 4.67 times in 2015 when compared with that in 2009.Generally, the DDDs value of erlotinib showed a decreasing trend, however, that of icotinib and gefitinib rose year by year during 2009 and 2015.Erlotinib had the highest DDC followed by gefitinib and icotinib.The mean value of DUI of the three targeted drugs was about 1.Conclusion: The utilization of EGFR-TKI is reasonable in 11 hospitals of Zhejiang province with increasing comsuption.