Methadona as a first-line treatment for cancer pain in a palliative care unit in a developing country

PEIRANO, GABRIELA; RUSSO, JORGELINA; MAMMANA, GUILLERMO; BERTOLINO, MARIELA; VEGA, FANNY; PASTRANA, TANIA; RUGGIERO, RAÚL; ARMESTO, ARNALDO; CAMERANO, GABRIELA VERÓNICA; DRAN, GRACIELA

Viena

Congreso; 18th ECCO - 40th ESMO European Cancer Congress; 2015

ECCO

Methadone is increasingly being used to manage cancer pain in developing countries, mainly because of its long acting effect at low cost. However, there exists little information about its use as the first- line alternative for cancer patients requiring strong opioids. The aim of this study was to describe the characteristics of prescription of methadone among other strong opioids as the initial choice to treat moderate to severe cancer pain at a Tertiary Palliative Care Unit (PCU) in a public hospital in Argentina. Methods: Retrospective analysis based on the records of all new opioid- naïve patients with moderate to severe cancer pain referred to palliative care consultation from July 2012 to June 2013, and who were indicated strong opioids in the first consult. Collected data included type and dose of opioid, variations in the intensity of pain and need and reasons for opioid rotation (OR) during the first month of treatment. Results: Out of 72 patients who met the inclusion criteria, 56 medical records were recovered from the Hospital Registry. At baseline, most (56%) had ECOG score of 3-4, mixed pain and exhibited poor prognostic factors for pain control. Methadone was the most frequent opioid both initially (71%) and at the last assessment (66%). The initial and final opioid doses were similar (oral morphine equivalent daily dose 28.2 ± 14.4, n=56 vs 41 ± 21.3, n=42, respectively; p=0.6) for all opioids, although significant decrease in the intensity of pain was achieved (p