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| Comparison of the efficacy and safety of two⁃step and three⁃step strategy in the treatment of moderate cancer pain |
| 1Liu Ke, 1Jiao Xiaodong, 2Zhou Xincheng, 1Qin Baodong, 1Wu Ying, 1Ling Yan, 1He Xi, 1Zang Yuansheng |
| 1Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai 200070, China；2Department of Internal
Medicine, People′s Hospital of Qingyang County, Chizhou 242800, Anhui，China |
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Abstract Patients with cancer often experience pain that affects their daily activities and quality of life. The inadequate
pain treatments for patients who suffered from the moderate pain are still existed though the analgesic ladder recommended by
the World Health Organization contributed outstanding. Current international guidelines recognize that low doses of a step Ⅲ opioid may be used instead of the step Ⅱ for patients with mild⁃moderate pain, although such recommendations are weak. These
previous studies showed that to abolish the second step and start directly with a step three opioid will effectively control the pain
better with less adverse effects. The effect of clinical analgesia treatment is affected by many factors. In addition to the different
efficacy between the step Ⅱ and Ⅲ, the actual conditions such as cancer therapy (antitumor therapy or palliative care), pain
types and living distance to the hospital affect the outcome of the patients. Therefore, clinicians need to formulate the analgesic
strategy with multi⁃dimensional evaluations in order to improve the curative effect of moderate cancer pain. In our paper, we
made efforts to evaluate the efficacy, tolerability and the factors related to adherence to long⁃term opioid therapy of low doses of
morphine in comparison with standard doses of weak opioids in the treatment of moderate cancer pain in opioid⁃naive patients in
order to provide more references for clinical job.
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Received: 15 December 2020
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