Page 59 - CPG - Clinical Practice Guidelines - Management of Cancer Pain

Management of Cancer Pain (Second Edition)

life in patients with chemo-sensitive or hormone-sensitive cancers e.g.
breast cancer, lung cancer, prostate cancer, lymphoma, ovarian cancer
and germ cell tumour. 9

The treatment landscape of anti cancer therapy has changed with the
emergence of immunotherapy. However, the role of immunotherapy in
the management of cancer pain is still limited.
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analysis comparing four types of anticancer therapy (immunotherapy,
chemotherapy, radiotherapy and targeted therapy) in cancer pain, the
¿QGLQJV ZHUH 80, level II-2
{ the total oral morphine equivalent daily dose (OMED)(mg) q/day
DQG 156 VFRUHV GHFUHDVHG VLJQL¿FDQWO\ LQ SDWLHQWV UHFHLYLQJ
immunotherapy
{ compared with the other three treatment groups, the OMED (mg)
T GD\ DQG 156 ZHUH VLJQL¿FDQWO\ ORZHU LQ WKH LPPXQRWKHUDS\
group after treatment
{ fewer AEs were shown in the immunotherapy group compared
with the other three groups

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The use of radionuclide therapy for metastatic bone pain, especially in
diffuse disease or refractory bone pain is an option.

A systematic review on pain response (partial and complete response)
RI GLIIHUHQW ERQH VHHNLQJ UDGLRSKDUPDFHXWLFDOV 6P 5H 5H
and 223Ra) for palliation of malignant bone pain from prostate cancer
showed: 81, level I
{ pain response of greater than 50 - 60% with each radionuclide
{ ORZ LQFLGHQFH RI JUDGH DQG KDHPDWRORJLFDO WR[LFLW\

There was limited data on the use of radionuclide seeds in metastatic
bone pain. 82, level II-1 In view of high cost, limited data and availability,
radionuclide and radiation seeds therapy are not a routine option for
cancer-related bone pain in this country. Thus, no recommendation can
be formulated on its use.

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