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Effectiveness of fentanyl pectin nasal citrate in controlling episodes of breakthrough cancer pain triggered by routine radiotherapy procedures

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Abstract

Purpose

The aim of the study was to evaluate the effectiveness of fentanyl pectin nasal spray (FPNS) in controlling procedural breakthrough cancer pain (BTCP) in advanced cancer patients undergoing radiotherapy.

Materials and methods

This study involved 62 advanced cancer patients, with well-controlled background pain, who presented BTCP associated to routine radiotherapy procedures, treated with FPNS according to our protocol of administration. The BPE intensity was measured using a visual analog scale (VAS).

Results

The BTCP was triggered during the computed tomography simulation (79.3%) or treatment delivery (20.7%). Patients indicated a mean VAS of 8.8 (range 7–10) when attempting the procedure. After 4.5 min (range 2–10) of the first FPNS dose, the majority of patients (85.5%) indicated a VAS of 4.3 (range 2–6). 15.5% of the patients did not respond after 15 min; requiring a second dose. All these patients responded, reporting a mean VAS of 4.2 (range 4–6) after 3.0 min (range 2–5) of the second dose. None of the patients required a third dose, nor reported an AE after the administration of FPNS.

Conclusions

In our knowledge, our study is the one of highest recruitment, and with the fastest response of BTCP treated with FPNS reported in advanced cancer patients undergoing radiotherapy. FPNS has proven to be highly effective in reducing the intensity of procedural BTCP in a very short period of time.

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Acknowledgements

Authors would thank to Pablo Vivanco (PhD, Meisys) for helping in the elaboration of the manuscript.

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Authors and Affiliations

  1. Radiation Oncology Department, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07010, Palma de Mallorca, Spain

    J. Pardo, A. Mena, E. Jiménez, N. Aymar, I. Ortiz, R. Roncero, F. Mestre & M. Vidal

  2. Institut d’Investigació Sanitaria de Palma (IdISPa), Palma de Mallorca, Spain

    J. Pardo, A. Mena & E. Jiménez

  3. Hospital Universitari General de Catalunya, Quirónsalud, Barcelona, Spain

    J. Pardo

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  1. J. Pardo
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Correspondence to J. Pardo.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Because fentanyl pectin nasal citrate is an approved drug for the treatment of breakthrough pain, ethical approval is not necessary. However the study has been ethically approved.

Informed consent

All patients signed the informed consent to participate in the study.

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Pardo, J., Mena, A., Jiménez, E. et al. Effectiveness of fentanyl pectin nasal citrate in controlling episodes of breakthrough cancer pain triggered by routine radiotherapy procedures. Clin Transl Oncol 21, 1568–1572 (2019). https://doi.org/10.1007/s12094-019-02125-8

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  • DOI: https://doi.org/10.1007/s12094-019-02125-8

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