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. 2017 Jul 24;7(7):CD012563.
doi: 10.1002/14651858.CD012563.pub2.

Non-steroidal anti-inflammatory drugs (NSAIDs) for cancer-related pain in children and adolescents

Tess E Cooper  1 , Lauren C Heathcote, Brian Anderson, Marie-Claude Grégoire, Gustaf Ljungman, Christopher Eccleston
Affiliations

Non-steroidal anti-inflammatory drugs (NSAIDs) for cancer-related pain in children and adolescents

Tess E Cooper et al. Cochrane Database Syst Rev. .

Abstract

Background: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for persisting pain in children acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences.We designed a suite of seven reviews in chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, non-steroidal anti-inflammatory drugs, opioids, and paracetamol as priority areas) to review the evidence for children's pain using pharmacological interventions.As one of the leading causes of mortality and morbidity for children and adolescents in the world today, childhood cancer (and its associated pain) is a major health concern. Specific mortality and morbidity data relating to children are not currently identified. All childhood cancer rates are on the rise; for example, in the USA approximately 10,380 children aged under 15 years were expected to be diagnosed with cancer by the end of 2016. However, with survival rates also increasing, over 80% of paediatric cancer patients are expected to survive for five years or more, thus identifying the need to address pain management in this population.Cancer pain in infants, children, and adolescents is primarily nociceptive pain with negative long term effects. Cancer-related pain is generally caused directly by the tumour itself such as compressing on the nerve or inflammation of the organs. Cancer-related pain generally occurs as a result of perioperative procedures, nerve damage caused by radiation or chemotherapy treatments, or mucositis. However, this review focused on pain caused directly by the tumour itself such as nerve infiltration, external nerve compression, and other inflammatory events.Non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat pain, reduce fever, and for their anti-inflammatory properties. They are commonly used within paediatric pain management. NSAIDs are currently licensed for use in western countries, however not approved for infants aged under three months. Primary adverse effects include gastrointestinal issues and possible renal impairment with long term use. Other adverse effects in children include diarrhoea, headache, nausea, constipation, rash, dizziness, and abdominal pain.

Objectives: To assess the analgesic efficacy, and adverse events, of non-steroidal anti-inflammatory drugs (NSAIDs) used to treat cancer-related pain in children and adolescents aged from birth and 17 years, in any setting.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online, MEDLINE via Ovid, and Embase via Ovid from inception to 21 February 2017. We also searched the reference lists of retrieved studies and reviews, and searched online clinical trial registries.

Selection criteria: Randomised, double-blind trials of any dose, and any route, treating cancer-related pain in children and adolescents, comparing NSAIDs with placebo or an active comparator.

Data collection and analysis: Two review authors independently assessed studies for eligibility. We planned to use dichotomous data to calculate risk ratio and number needed to treat for one additional event, using standard methods. We assessed GRADE (Grading of Recommendations Assessment, Development and Evaluation) and planned to create a 'Summary of findings' table.

Main results: No studies were eligible for inclusion in this review (very low quality evidence). We downgraded the quality of evidence by three levels due to the lack of data reported for any outcome.

Authors' conclusions: There is no evidence from randomised controlled trials that non-steroidal anti-inflammatory drugs (NSAIDs) reduce cancer-related pain in children and adolescents. This means that no reliance or conclusions can be made about efficacy or harm in the use of NSAIDs to treat chronic cancer-related pain in children and adolescents.

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Conflict of interest statement

CE: none known. Since CE is an author as well as the PaPaS Co‐ordinating Editor at the time of writing, we acknowledge the input of Leontien Kremer, of the Cochrane Childhood Cancer Group, who acted as Sign Off Editor for this review. CE had no input into the editorial decisions or processes for this review.

TC: none known.

BA: none known; BA is a specialist anaesthetist and intensive care physician and manages the perioperative care of children requiring surgery and those critically ill requiring intensive care.

MCG: none known; MCG is a specialist paediatric pain and palliative care physician and treats patients with complex pain.

LH: none known.

GL: none known; GL is a specialist paediatric oncologist and paediatric pain physician and manages patients with cancer and cancer pain.

Figures

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1
Study flow diagram.
See this image and copyright information in PMC

Update of

References

References to studies excluded from this review

Bottner 2001 {published data only}
    1. Bottner F, Roedl R, Wortler K, Grethen C, Winkelmann W, Lindner N. Cyclooxygenase‐2 inhibitor for pain management in osteoid osteoma. Clinical Orthopaedics and Related Research 2001;393:258‐63. - PubMed
Cappelaere 1971 {published data only}
    1. Cappelaere P, Adenis L, Driessens J. Value of injectable aspirin in cancerology. Lille Medical 1971;17(3):566‐71. - PubMed
Gross 2003 {published data only}
    1. Gross M, Dano I, Hocwald E, Eliashar R. Osteoid osteoma of the frontal bone. Annals of Otology, Rhinology, and Laryngology 2003;112(6):567‐8. - PubMed
Harris 2003 {published data only}
    1. Harris JT, Suresh Kumar K, Rajagopal MR. Intravenous morphine for rapid control of severe cancer pain. Palliative Medicine 2003;17(3):248‐56. - PubMed
Lauretti 1998 {published data only}
    1. Lauretti GR, Reis MP, Mattos Al, Gomes JM, Oliveria AP, Pereira NL. Epidural nonsteroidal antiinflammatory drugs for cancer pain. Anesthesia and Analgesia 1998;86(1):117‐8. - PubMed
Mercandante 1999 {published data only}
    1. Mercadante S. Pain treatment and outcomes for patients with advanced cancer who receive follow‐up care at home. Cancer 1999;85(8):1849‐58. - PubMed
Sittl 1991 {published data only}
    1. Sittl R, Richter R. Cancer pain therapy in children and adolescents using morphine. Der Anaesthesist 1991;40(2):96‐9. - PubMed
Toscani 1994 {published data only}
    1. Toscani F, Piva L, Corli O, Gallucci M, Speranza R, Tamburini M, et al. Ketorolac versus diclofenac sodium in cancer pain. Arzneimittel‐Forschung 1994;44(4):550‐4. - PubMed
Zhen 2007 {published data only}
    1. Zhen ZJ, Sun XF, Xia Y, Ling JY, Zheng L, Luo WB, et al. Feasibility to treat pediatric cancer pain with analgesics for adults and their efficacy. Chinese Journal of Cancer 2007;26(8):866‐9. - PubMed

Additional references

ACS 2015
    1. American Cancer Society. Cancer in children. www.cancer.org/cancer/cancerinchildren/detailedguide/cancer‐in‐children‐... (accessed 16 July 2016).
AMA 2013
    1. American Medical Association. Paediatric pain management. https://www.ama‐assn.org/ (accessed 25 January 2016).
AUREF 2012
    1. Cochrane Pain, Palliative and Supportive Care Group. PaPaS author and referee guidance. papas.cochrane.org/papas‐documents (accessed 16 July 2016).
Blanca‐López 2015
    1. Blanca‐López N, Cornejo‐García JA, Plaza‐Serón MC, Doña I, Torres‐Jaén MJ, Canto G, et al. Hypersensitivity to nonsteroidal anti‐inflammatory drugs in children and adolescents: cross‐intolerance reactions. Journal of Investigational Allergology & Clinical Immunology 2015;25(4):259‐69. - PubMed
BNF 2016
    1. Joint Formulary Committee. British National Formulary. London (UK): BMJ Group and Pharmaceutical Press, 2016.
Caes 2016
    1. Caes L, Boemer KE, Chambers CT, Campbell‐Yeo M, Stinson J, Birnie KA, et al. A comprehensive categorical and bibliometric analysis of published research articles on pediatric pain from 1975 to 2010. Pain 2016;157(2):302‐13. [DOI: 10.1097/j.pain.0000000000000403] - DOI - PubMed
Calvo 2012
    1. Calvo M, Dawes JM, Bennett DL. The role of the immune system in the generation of neuropathic pain. Lancet Neurology 2012;11(7):629‐42. [DOI: 10.1016/S1474-4422(12)70134-5] - DOI - PubMed
Cooper 2017a
    1. Cooper TE, Fisher E, Gray A, Krane E, Sethna NF, Tilburg M, et al. Opioids for chronic non‐cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 7. [DOI: 10.1002/14651858.CD012538.pub2] - DOI - PMC - PubMed
Cooper 2017b
    1. Cooper TE, Heathcote L, Clinch J, Gold J, Howard R, Lord S, et al. Antidepressants for chronic non‐cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 8. [DOI: 10.1002/14651858.CD012535.pub2] - DOI - PMC - PubMed
Cooper 2017c
    1. Cooper TE, Fisher E, Anderson B, Wilkinson N, Williams G, Eccleston C. Paracetamol (acetaminophen) for chronic non‐cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 8. [DOI: 10.1002/14651858.CD012539.pub2] - DOI - PMC - PubMed
Derry 2017
    1. Derry S, Wiffen PJ, Moore RA, McNicol ED, Bell RF, Carr DB, et al. Oral nonsteroidal anti‐inflammatory drugs (NSAIDs) for cancer pain in adults. Cochrane Database of Systematic Reviews 2017, Issue 4. [DOI: 10.1002/14651858.CD012638] - DOI - PMC - PubMed
Dowell 2016
    1. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain ‐ United States. JAMA 2016;315(15):1624‐45. - PMC - PubMed
Dworkin 2008
    1. Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. Journal of Pain 2008;9(2):105‐21. [DOI: 10.1016/j.jpain.2007.09.005] - DOI - PubMed
Eccleston 2003
    1. Eccleston C, Malleson PM. Management of chronic pain in children and adolescents. We need to address the embarrassing lack of data for this common problem. BMJ 2003;326(7404):1408‐9. - PMC - PubMed
Eccleston 2017
    1. Eccleston C, Cooper TE, Fisher E, Anderson B, Wilkinson N. Non‐steroidal anti‐inflammatory drugs (NSAIDs) for chronic non‐cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 8. [DOI: 10.1002/14651858.CD012537.pub2] - DOI - PMC - PubMed
Frankish 2003
    1. Frankish H. 15 million new cancer cases per year by 2020, says WHO. Lancet 2003;361(9365):1278. - PubMed
Guyatt 2008
    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck‐Ytter Y, Alonso‐Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924‐6. [DOI: 10.1136/bmj.39489.470347.AD] - DOI - PMC - PubMed
Guyatt 2011
    1. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE Guidelines: 1. Introduction‐GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology 2011;64(4):383‐94. [DOI: 10.1016/j.jclinepi.2010.04.026] - DOI - PubMed
Guyatt 2013a
    1. Guyatt G, Oxman AD, Sultan S, Brozek J, Glasziou P, Alonso‐Coelle P, et al. Making an overall rating of the confidence in effect estimates for a single outcome and for all outcomes. Journal of Clinical Epidemiology 2013;66(2):151‐7. [DOI: 10.1016/j.jclinepi.2012.01.006] - DOI - PubMed
Guyatt 2013b
    1. Guyatt GH, Oxman AD, Santesso N, Helfand M, Vist G, Kunz R, et al. GRADE guidelines: 12. Preparing summary of findings tables‐binary outcomes. Journal of Clinical Epidemiology 2013;66(2):158‐72. [DOI: 10.1016/j.jclinepi.2012.01.012] - DOI - PubMed
Hasnie 2007
    1. Hasnie FS, Breuer J, Parker S, Wallace V, Blackbeard J, Lever I, et al. Further characterization of a rat model of varicella zoster virus‐associated pain: Relationship between mechanical hypersensitivity and anxiety‐related behavior, and the influence of analgesic drugs. Neuroscience 2007;144(4):1495‐508. [DOI: 10.1016/j.neuroscience.2006.11.029] - DOI - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Hoffman 2010
    1. Hoffman DL, Sadosky A, Dukes EM, Alvir J. How do changes in pain severity levels correspond to changes in health status and function in patients with painful diabetic peripheral neuropathy?. Pain 2010;149(2):194‐201. [DOI: 10.1016/j.pain.2009.09.017] - DOI - PubMed
IARC 2008
    1. International Association on the Research of Cancer. Global cancer facts & figures. www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/doc... (accessed 7 March 2016).
Kaatsch 2010
    1. Kaatsch P. Epidemiology of childhood cancer. Cancer Treatment Reviews 2010;36(4):277‐85. [DOI: 10.1016/ctrv.2010.02.003] - DOI - PubMed
Kawakami 2002
    1. Kawakami M, Matsumoto T, Hashizume H, Kuribayashi K, Tamaki T. Epidural injection of cyclooxygenase‐2 inhibitor attenuates pain‐related behavior following application of nucleus pulposus to the nerve root in the rat. Journal of Orthopaedic Research 2002;20(2):376‐81. [DOI: 10.1016/S0736-0266(01)00114-0] - DOI - PubMed
L'Abbé 1987
    1. L'Abbé KA, Detsky AS, O'Rourke K. Meta‐analysis in clinical research. Annals of Internal Medicine 1987;107(2):224‐33. - PubMed
Lesko 1995
    1. Lesko SM, Mitchell AA. An assessment of the safety of pediatric ibuprofen. Journal of the American Medical Association 1995;273(12):929‐33. - PubMed
Lesko 1997
    1. Lesko SM, Mitchell AA. Renal function after short‐term ibuprofen use in infants and children. Pediatrics 1997;100(6):954‐7. - PubMed
Lesko 1999
    1. Lesko SM, Mitchel AA. The safety of acetaminophen and ibuprofen among children younger than two years old. Pediatrics 1999;104(4):e39. - PubMed
Ljungman 1996
    1. Ljungman G, Kreuger A, Gordh T, Berg T, Sörensen S, Rawal N. Treatment of pain in pediatric oncology: a Swedish nationwide surgery. Pain 1996;68(2‐3):385‐94. - PubMed
McQuay 1998
    1. McQuay H, Moore R. An Evidence‐based Resource for Pain Relief. Oxford (UK): Oxford University Press, 1998.
Misurac 2013
    1. Misurac JM, Knoderer CA, Leiser JD, Nailsecu C, Wilson AC, Andreoli SP. Nonsteroidal anti‐inflammatory drugs are an important cause of acute kidney injury in children. Journal of Pediatrics 2013;162(6):1153‐9. [DOI: 10.1016/j.jpeds.2012.11.069] - DOI - PubMed
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, the PRISMA Group. Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. PLoS Medicine 2009;6(7):e1000097. - PMC - PubMed
Moore 2008
    1. Moore RA, Barden J, Derry S, McQuay HJ. Managing potential publication bias. In: McQuay HJ, Kalso E, Moore RA editor(s). Systematic Reviews in Pain Research: Methodology Refined. Seattle (WA): IASP Press, 2008:15‐24. [ISBN: 978‐0‐931092‐69‐5]
Moore 2009
    1. Moore RA, Straube S, Wiffen PJ, Derry S, McQuay HJ. Pregabalin for acute and chronic pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD007076.pub2] - DOI - PMC - PubMed
Moore 2010a
    1. Moore RA, Eccleston C, Derry S, Wiffen P, Bell RF, Straube S, et al. "Evidence" in chronic pain ‐ establishing best practice in the reporting of systematic reviews. Pain 2010;150(3):386‐9. [DOI: 10.1016/j.pain.2010.05.011] - DOI - PubMed
Moore 2010b
    1. Moore RA, Straube S, Paine J, Phillips CJ, Derry S, McQuay HJ. Fibromyalgia: moderate and substantial pain intensity reduction predicts improvement in other outcomes and substantial quality of life gain. Pain 2010;149(2):360‐4. - PubMed
Moore 2010c
    1. Moore RA, Moore OA, Derry S, Peloso PM, Gammaitoni AR, Wang H. Responder analysis for pain relief and numbers needed to treat in a meta‐analysis of etoricoxib osteoarthritis trials: bridging a gap between clinical trials and clinical practice. Annals of the Rheumatic Diseases 2010;69(2):374‐9. [DOI: 10.1136/ard.2009.107805] - DOI - PMC - PubMed
Moore 2010d
    1. Moore RA, Smugar SS, Wang H, Peloso PM, Gammaitoni A. Numbers‐needed‐to‐treat analyses ‐ do timing, dropouts, and outcome matter? Pooled analysis of two randomized, placebo‐controlled chronic low back pain trials. Pain 2010;151(3):592‐7. [DOI: 10.1016/j.pain.2010.07.2013] - DOI - PubMed
Moore 2010e
    1. Moore RA, Derry S, McQuay HJ, Straube S, Aldington D, Wiffen P, et al. ACTINPAIN writing group of the IASP Special Interest Group (SIG) on Systematic Reviews in Pain Relief. Clinical effectiveness: an approach to clinical trial design more relevant to clinical practice, acknowledging the importance of individual differences. Pain 2010;149(2):173‐6. [PUBMED: 19748185] - PubMed
Moore 2011a
    1. Moore RA, Straube S, Paine J, Derry S, McQuay HJ. Minimum efficacy criteria for comparisons between treatments using individual patient meta‐analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen, and ibuprofen/paracetamol combinations after third molar extraction. Pain 2011;152(5):982‐9. [DOI: 10.1016/j.pain.2010.11.030] - DOI - PubMed
Moore 2011b
    1. Moore RA, Mhuircheartaigh RJ, Derry S, McQuay HJ. Mean analgesic consumption is inappropriate for testing analgesic efficacy in post‐operative pain: analysis and alternative suggestion. European Journal of Anaesthesiology 2011;28(6):427‐32. [DOI: 10.1097/EJA.0b013e328343c569] - DOI - PubMed
Moore 2012
    1. Moore RA, Straube S, Eccleston C, Derry S, Aldington D, Wiffen P, et al. Estimate at your peril: imputation methods for patient withdrawal can bias efficacy outcomes in chronic pain trials using responder analyses. Pain 2012;153(2):265‐8. [DOI: 10.1016/j.pain.2011.10.004] - DOI - PubMed
Moore 2013a
    1. Moore RA, Straube S, Aldington D. Pain measures and cut‐offs ‐ 'no worse than mild pain' as a simple, universal outcome. Anaesthesia 2013;68(4):400‐12. [DOI: 10.1111/anae.12148] - DOI - PubMed
Moore 2013b
    1. Moore A, Derry S, Eccleston C, Kalso E. Expect analgesic failure; pursue analgesic success. BMJ 2013;346:f2690. [DOI: 10.1136/bmj.f2690] - DOI - PubMed
Moore 2014a
    1. Moore RA, Derry S, Taylor RS, Straube S, Phillips CJ. The costs and consequences of adequately managed chronic non‐cancer pain and chronic neuropathic pain. Pain Practice 2014;14(1):79‐94. - PubMed
Moore 2014b
    1. Moore RA, Cai N, Skljarevski V, Tölle TR. Duloxetine use in chronic painful conditions ‐ individual patient data responder analysis. European Journal of Pain 2014;18(1):67‐75. [DOI: 10.1002/j.1532-2149.2013.00341.x] - DOI - PMC - PubMed
NICE 2015
    1. National Institute of Health and Care Excellence (NICE). Guidance ‐ sickle cell acute painful episode. https://www.nice.org.uk/guidance/cg143/evidence/full‐guideline‐pdf‐18663... (accessed 7 September 2015).
O'Brien 2010
    1. O'Brien EM, Staud RM, Hassinger AD, McCulloch RC, Craggs JG, Atchinson JW, et al. Patient‐centered perspective on treatment outcomes in chronic pain. Pain Medicine 2010;11(1):6‐15. [DOI: 10.1111/j.1526-4637.2009.00685.x] - DOI - PubMed
PedIMMPACT 2008
    1. McGrath PJ, Walco GA, Turk DC, Dworking RH, Brown MT, Davidson K, et al. Core outcome domains and measures for pediatric acute and chronic/recurrent pain clinical trials: PedIMMPACT. Journal of Pain 2008;9(9):771‐83. - PubMed
Review Manager 2014 [Computer program]
    1. Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager 5 (RevMan 5). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Ripamonti 2008
    1. Ripamonti C, Bandieri E. Pain therapy. Journal of Hematology & Oncology 2008;70(2):145‐59. [DOI: 10.1016/j.critrevonc.2008.12.005] - DOI - PubMed
Stinson 2006
    1. Stinson JN, Kavanagh T, Yamada J, Gill N, Stevens B. Systematic review of the psychometric properties, interpretability and feasibility of self‐report pain intensity measures for use in clinical trials in children and adolescents. Pain 2006;125(1‐2):143‐57. [DOI: 10.1016/j.pain.2006.05.006] - DOI - PubMed
Straube 2008
    1. Straube S, Derry S, McQuay HJ, Moore RA. Enriched enrolment: definition and effects of enrichment and dose in trials of pregabalin and gabapentin in neuropathic pain. A systematic review. British Journal of Clinical Pharmacology 2008;66(2):266‐75. [DOI: 10.1111/j.1365-2125.2008.03200.x] - DOI - PMC - PubMed
Straube 2010
    1. Straube S, Derry S, Moore RA, Paine J, McQuay HJ. Pregabalin in fibromyalgia ‐ responder analysis from individual patient data. BMC Musculoskeletal Disorders 2010;11:150. [DOI: 10.1186/1471-2474-11-150] - DOI - PMC - PubMed
Sultan 2008
    1. Sultan A, Gaskell H, Derry S, Moore RA. Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials. BMC Neurology 2008;8:29. [DOI: 10.1186/1471-2377-8-29] - DOI - PMC - PubMed
Tanko 2009
    1. Tanko NM, Echejoh GO, Manasseh NA, Mandong MB, Uba AF. Paediatric solid tumours in Nigerian children: a changing pattern. African Journal of Paediatric Surgery 2009;6(1):7‐10. - PubMed
United Nations 2017
    1. United Nations. World Population Prospects 2017 ‐ Population Indicators. esa.un.org/unpd/wpp/Download/Standard/Population (accessed prior to 3 July 2017).
Vo 2009
    1. Vo T, Rice ASC, Dworkin RH. Non‐steroidal anti‐inflammatory drugs for neuropathic pain: How do we explain continued widespread use?. Pain 2009;143(3):169‐71. [DOI: 10.1016/j.pain.2009.03.013] - DOI - PubMed
Von Baeyer 2007
    1. Baeyer CL, Spagrud LJ. Systematic review of observational (behavioural) measures of pain for children and adolescents aged 3 to 18 years. Pain 2007;127(1‐2):140‐50. [DOI: 10.1016/j.pain.2006.08.014] - DOI - PubMed
WHO 1998
    1. World Health Organization. Cancer pain relief and palliative care in children. apps.who.int/iris/bitstream/10665/42001/1/9241545127.pdf (accessed prior to 3 July 2017).
WHO 2011
    1. World Health Organization. Cancer Fact Sheet N°297. www.who.int/mediacentre/factsheets/fs297/en/ (accessed 06 March 2017).
WHO 2012
    1. World Health Organization. WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses. apps.who.int/iris/bitstream/10665/44540/1/9789241548120_Guidelines.pdf (accessed prior to 3 July 2017). [ISBN: 978 92 4 154812 0] - PubMed
Wiffen 2017a
    1. Wiffen PJ, Cooper TE, Anderson AK, Gray A, Grégoire MC, Ljungman G, et al. Opioids for cancer‐related pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 7. [DOI: 10.1002/14651858.CD012564.pub2] - DOI - PMC - PubMed
Wiffen 2017b
    1. Wiffen PJ, Cooper TE, Heathcote L, Clinch J, Howard R, Krane E, et al. Antiepileptic drugs for chronic non‐cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 8. [DOI: 10.1002/14651858.CD012536.pub2] - DOI - PMC - PubMed
World Bank 2016
    1. The World Bank. Data ‐ population ages 0‐14 (% of total). data.worldbank.org/indicator/SP.POP.0014.TO.ZS (accessed 29 February 2016).

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