Effectiveness of Fentanyl Transdermal Patch (Fentanyl-TTS, Durogegic(R)) for Radiotherapy Induced Pain and Cancer Pain: Multi-center Trial / 대한방사선종양학회지

PURPOSE: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. MATERIALS AND METHODS: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. RESULTS: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. CONCLUSION: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.

The clinical and radiological observation of 80 cases of leukemia

The leukemias are the most common form of childhood cancer. The same kinds of leukemia are found in childrenand in adults. Because the radiologist is involved in the initial diagnosis, the evaluation of response to therapyand demonstration of complications, it is important that he understands the clinical and radiological features ofleukemia. This report is a clinical and radiological review of 80 cases who visited to Chonnam National UniversityHospital from Jan. 1977 to June 1981. The results are summarized as follows. 1. Most prevalent group of age wasbetween 10 to 14 years old(25%) and male was affected more frequently than female with the ratio of 1.4:1. Acuteform of leukemia was 95% and acute myelocytic leukemia was more frequent than acute lymphocytic leukemia. 2.Pallor with anemic conjuctiva was the most prominent clinical manifestation of the leukemia. Fever was the mostcommon symptom in childhood leukemia and general weakness was the most common in adult leukemia. 3. Hematologicexamination revealed marked anemia(Hemoglobin level was less than 8.0gm/100ml in 65%). In 17.5% the leukocytecount was less than 5,000/cu.mm and more than 10,000/cu.mm in 65%. Platelet count was less than 50,000/cu/mm in 23.8% and between 50,000 and 150,000/cu.mm in 43.7%. 4. The abnormal findings in chest X-ray films were observedin 35%. Pneumonia(18.8%) was the most common and lymphadenopathy(17.5%), pleural effusion(12.5%), leukemicinfiltration (3.75%), pulmonary congestion and pulmonary edema(3.75%) were descending order of frequency. 5. Theabnormal findings in long bone X-ray films were observed in 75% and the bone changes were more frequent in acutelymphocytic leukemia (57.1%) than in acute myelocytic leukemia(17.9%). Metaphseal transverse radiolucent band(75.0%) was the most common and osteolytic lesion(60.7%), periosteal reaction (35.7%), osteosclerosis(7.1%) were descending order of frequency. 6. The common sites of bony changes were femur(75%), tibia(57.1%), fibular(57.1%)humerus, radius and ulna in order of frequency. 7. In 35.7% of the cases who complained of bone or joint pain withabnormal findings in long bone x-ray films, leukocyte count was less than 5,000/cu.mm.