1.Current issues in the opioid therapy for advanced hepatocellular carcinoma
Kazuto Tajiri ; Yukiko Yasukawa ; Syo Furusawa ; Yasuko Kubota ; Shingo Chikaoka ; Kengo Kawai ; Masami Minemura ; Satoshi Yasumura ; Terumi Takahara ; Toshiro Sugiyama
Palliative Care Research 2014;9(1):101-106
Backgraund/Aim/Method: Hepatocellular carcinoma (HCC) is a serious life-threatening disease. When HCC is advanced, moderate to severe pain is frequently found due to bone metastasis, requiring the administration of opioids. However, HCC develops in cirrhotic liver in most cases those are decreased in drug metabolism. Careful monitoring is therefore required when opioids are administered to patients with cirrhosis or HCC because guidelines about the administration of opioids are not established in Japan. In this report, we retrospectively analyzed cases treated by opioids and discussed about problems in current opioid treatment for advanced HCC cases. Results: The median duration of opioid treatment is about two months, and seems to be prolonged in cases with treatment of HCC. Prophylaxes for hepatic encephalopathy were done in about 10% of cases, and hepatic encephalopathy was developed in about 40% of cases after opioid treatment. Conclusion: In administration of opioids for advanced HCC, we should consider the onset of hepatic encephalopathy and make an effort to prevent it.
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