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. 2017 Jun;20(6):656-661.
doi: 10.1089/jpm.2016.0316. Epub 2016 Dec 20.

Overall Survival among Cancer Patients Undergoing Opioid Rotation to Methadone Compared to Other Opioids

Akhila Reddy  1 , Ulrich S Schuler  2 , Maxine de la Cruz  1 , Sriram Yennurajalingam  1 , Jimin Wu  3 , Diane Liu  3 , Eduardo Bruera  1
Affiliations

Overall Survival among Cancer Patients Undergoing Opioid Rotation to Methadone Compared to Other Opioids

Akhila Reddy et al. J Palliat Med. 2017 Jun.

Abstract

Background: Methadone has been associated with lower overall survival (OS) in patients with chronic pain. There are no data available on the association of methadone with OS in cancer patients.

Objective: Our aim was to compare the OS in cancer outpatients undergoing opioid rotation (OR) to methadone and other strong opioids.

Design: Demographics, symptoms, and morphine equivalent daily dose (MEDD) were collected in patients who underwent OR from strong opioids to either methadone or other strong opioids and returned for a follow-up within six weeks.

Setting/subjects: Nine hundred thirty-eight consecutive outpatients to the supportive care center of a tertiary cancer center were reviewed.

Measurements: Kaplan-Meier curves were used to evaluate survival.

Results: Of a total of 164 eligible patients, 54/76 patients who underwent OR to methadone and 48/88 patients who underwent OR to other opioids returned for a follow-up visit. The median age was 56 years, 54% were male, and 87% had advanced cancer. There were no significant differences between the two groups in patient characteristics, performance status, MEDD, and pain scores. The Kaplan-Meier curves revealed no significant difference in median OS between all patients undergoing OR to methadone and other opioids [3.75 months (95% confidence interval, CI, 2.30-6.46) vs. 2.62 months (95% CI 1.74-4.33); p = 0.35] and also among those who returned for a follow-up following an OR to methadone and other opioids [5.15 months (95% CI 3.64-7.41) vs. 5.90 months (95% CI 2.62-9.28); p = 0.89].

Conclusions: We observed no significant difference in OS in cancer patients in methadone group compared to other opioids.

Keywords: cancer pain; cancer patients; methadone; mortality; opioid rotation; survival.

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Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Flow chart of eligible patients.
<b>FIG. 2.</b>
FIG. 2.
Kaplan–Meier Survival Estimates.
See this image and copyright information in PMC

Comment in

References

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