Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Pain Management Based on NCCN Guideline in Patients with Lung Cancer

NCCN 암성 통증 가이드라인에 따른 폐암 환자의 암성 통증 조절

  • Kim, Hyeon Tae (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Koh, Kyung Won (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Kim, Yeo Myeong (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Kang, Min Soo (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Noh, Hee Sun (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Kim, Hye-Ryoun (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Kim, Cheol Hyeon (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Lee, Jae Cheol (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences)
  • Received : 2009.07.17
  • Accepted : 2009.09.03
  • Published : 2009.09.30
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Abstract

Background: Pain is one of the most troublesome problems caused by malignancy. We evaluated the change in pain status according to observance of NCCN guidelines in lung cancer patients. Methods: Lung cancer patients complaining of pain at admission were examined. The pain was assessed with visual analogue scale (VAS) for 20 days and moderate-to-severe pain was defined as more than VAS level 3. The guideline observance was classified as high (more than 80%), medium (50~79%) and low (less than 50%). Results: Among the total 91 lung cancer patients with pain, 34 patients (37%) had moderate-to-severe pain. Their average VAS score at admission was 5.6. It decreased to 2.9 after a 20-day period of pain management. The time to reach a VAS less than 3 was 3 days in a high guideline observance group, while it took 6 days in a low observance group. In addition, the pain in the high observance group was controlled to less than 3 VAS level in 86% of patients, whereas only 25% of patients in the low observance group succeeded. Conclusion: Pain was more effectively controlled when the dose of drugs was modified according to NCCN guidelines in lung cancer patients indicating the importance of guideline observance in pain management.

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References

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