TRANSDERMAL FENTANYL FOR SEVERE CANCER-RELATED PAIN

A prospective phase II study was conducted to define the analgesic eff icacy, acceptability and toxicity of the transdermal therapeutic syste m (TTS) of fentanyl in Chinese patients with severe cancer-related pai n. A total of 14 patients was treated with TTS fentanyl at doses rangi ng from 25 to 100 mu g h(-1); initial doses were chosen according to t heir previous opioid requirement. Standard supportive therapy was give n as required. A brief pain inventory (using a 10-point scale) was use d to assess patients at days 0, 7 and 14. Pain control on day 14 with TTS fentanyl was successful in six patients, with a reduction in the c ommon side-effects of other opioids and improvement in general well-be ing. Seven patients did not complete the 14-day trial: two developed d izziness and nausea within 3 h of application; and in five, TTS fentan yl was insufficiently flexible to control increasing pain during the f irst week. TTS fentanyl was effective and well tolerated in 43% of pat ients. Acute dizziness and nausea within the first few hours after app lication and the relative inflexibility of dose-adjustment both limite d the use of TTS fentanyl.