Comparison of TD-fentanyl with sustained-release morphine in the pain treatment of patients with lung cancer

OBJECTIVE

The aim of this randomized and controlled trial was to evaluate the analgesic efficacy of trans-dermal fentanyl (TDF) and sustained-release oral morphine (SRM) primarily and their side effects secondarily, in patients with chronic lung cancer-related pain.

METHODS

According to three step analgesic guidelines recommended by the World Health Organization, 50 chronic lung cancer patients requiring third line therapy were enrolled and received either TDF patch (Grup F, n=25) or SRM per orally (Grup M, n=25) for 15 days. Patients were assessed in view to numeric rating scale of their pain, as well as the drugs' side effects like constipation, nausea-vomiting, urinary retention and urticaria, hypoventilation.

RESULTS

Pain scores were similar for both groups at the beginning (p>0.05). While significantly lower pain scores were achieved on the 7th and 15th days compared to those of initial values in Group F and Group M patients (p<0.001); these decreases did not reach statistical significance between the groups (p>0.05). Compared to Group M, constipation was significantly lower in Group F (14 patients and 64% vs. 6 patients and 27%, respectively) (p=0.03). However, the frequencies of nausea-vomiting, urinary retention and urticaria were different between the groups (p>0.5). None of the patients developed hypoventilation.

CONCLUSIONS

Both TDF and SRM are safe and effective analgesics for the management of chronic cancer pain. However, TDF is associated with significantly less constipation rate than that of with SRM.