Pain Management Based on NCCN Guideline in Patients with Lung Cancer / 결핵및호흡기질환

ABSTRACT

BACKGROUND: Pain is one of the most troublesome problems caused by malignancy. We evaluated the change in pain status according to observance of NCCN guidelines in lung cancer patients. METHODS: Lung cancer patients complaining of pain at admission were examined. The pain was assessed with visual analogue scale (VAS) for 20 days and moderate-to-severe pain was defined as more than VAS level 3. The guideline observance was classified as high (more than 80%), medium (50~79%) and low (less than 50%). RESULTS: Among the total 91 lung cancer patients with pain, 34 patients (37%) had moderate-to-severe pain. Their average VAS score at admission was 5.6. It decreased to 2.9 after a 20-day period of pain management. The time to reach a VAS less than 3 was 3 days in a high guideline observance group, while it took 6 days in a low observance group. In addition, the pain in the high observance group was controlled to less than 3 VAS level in 86% of patients, whereas only 25% of patients in the low observance group succeeded. CONCLUSION: Pain was more effectively controlled when the dose of drugs was modified according to NCCN guidelines in lung cancer patients indicating the importance of guideline observance in pain management.