Abstract：
BACKGROUND: Pain in cancer patients is a complex clinical problem. Pain is systematically assessed and treated during palliative care, but little is known about how it is addressed before starting palliative care.
OBJECTIVE: This study primarily analyzed pain, symptoms, ongoing therapy at patients\' admittance to the palliative care unit, and the relationships between pain and tumor, comorbidities, performance status and quality of life (QoL). Notably, patient satisfaction with the received antalgic therapy was assessed.
METHODS: A multicentric, prospective, observational study was conducted in seven Italian palliative centers. The population consisted of adult cancer patients admitted to specialist palliative care units in hospice and home care.
RESULTS: The sample consisted of 476 patients. Ninety-three patients reported moderate pain of 4.0 and worst pain of 5.9 at the initial medical examination. The pain was high, and QoL was lower in breakthrough pain. The pain was lower in older subjects when it was discontinuous and when it was also treated with corticosteroids. A total of 61% of the patients were unsatisfied with the prescribed pain therapy.
CONCLUSIONS: Before the beginning of palliative care, physicians do not manage pain adequately. We support the idea that palliative care is not only intended for the last days of life but must be started early and simultaneously with oncological treatments. All that, in our opinion, is often ignored, and we hope that our study could have a positive influence and that the study results stimulate further research in this area with in-depth studies.
OBJECTIVE: This study primarily analyzed pain, symptoms, ongoing therapy at patients\' admittance to the palliative care unit, and the relationships between pain and tumor, comorbidities, performance status and quality of life (QoL). Notably, patient satisfaction with the received antalgic therapy was assessed.
METHODS: A multicentric, prospective, observational study was conducted in seven Italian palliative centers. The population consisted of adult cancer patients admitted to specialist palliative care units in hospice and home care.
RESULTS: The sample consisted of 476 patients. Ninety-three patients reported moderate pain of 4.0 and worst pain of 5.9 at the initial medical examination. The pain was high, and QoL was lower in breakthrough pain. The pain was lower in older subjects when it was discontinuous and when it was also treated with corticosteroids. A total of 61% of the patients were unsatisfied with the prescribed pain therapy.
CONCLUSIONS: Before the beginning of palliative care, physicians do not manage pain adequately. We support the idea that palliative care is not only intended for the last days of life but must be started early and simultaneously with oncological treatments. All that, in our opinion, is often ignored, and we hope that our study could have a positive influence and that the study results stimulate further research in this area with in-depth studies.
摘要：
背景：癌症患者的疼痛是一个复杂的临床问题。在姑息治疗期间系统地评估和治疗疼痛，但在开始姑息治疗之前，人们对如何解决这一问题知之甚少。
目的：本研究主要分析疼痛，症状,患者进入姑息治疗单元的持续治疗，疼痛和肿瘤之间的关系，合并症,表现状况和生活质量(QoL)。值得注意的是,评估了患者对所接受的抗药治疗的满意度.
方法：多中心，prospective,观察性研究在7个意大利姑息治疗中心进行.人群包括成年癌症患者，这些患者被送往临终关怀和家庭护理的专业姑息治疗单位。
结果：样本包括476名患者。93例患者在初次体检时报告中度疼痛4.0，最差疼痛5.9。疼痛很高，突破性疼痛的QoL较低。当疼痛不连续且还用皮质类固醇治疗时，老年受试者的疼痛较低。共有61％的患者对规定的疼痛治疗不满意。
结论：在姑息治疗开始之前，医生不能充分控制疼痛。我们支持姑息治疗不仅适用于生命的最后几天，而且必须与肿瘤治疗同时开始。所有这些,在我们看来,经常被忽视，我们希望我们的研究能够产生积极的影响，并希望研究结果通过深入的研究促进这一领域的进一步研究。
目的：本研究主要分析疼痛，症状,患者进入姑息治疗单元的持续治疗，疼痛和肿瘤之间的关系，合并症,表现状况和生活质量(QoL)。值得注意的是,评估了患者对所接受的抗药治疗的满意度.
方法：多中心，prospective,观察性研究在7个意大利姑息治疗中心进行.人群包括成年癌症患者，这些患者被送往临终关怀和家庭护理的专业姑息治疗单位。
结果：样本包括476名患者。93例患者在初次体检时报告中度疼痛4.0，最差疼痛5.9。疼痛很高，突破性疼痛的QoL较低。当疼痛不连续且还用皮质类固醇治疗时，老年受试者的疼痛较低。共有61％的患者对规定的疼痛治疗不满意。
结论：在姑息治疗开始之前，医生不能充分控制疼痛。我们支持姑息治疗不仅适用于生命的最后几天，而且必须与肿瘤治疗同时开始。所有这些,在我们看来,经常被忽视，我们希望我们的研究能够产生积极的影响，并希望研究结果通过深入的研究促进这一领域的进一步研究。
