Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 18;18(1):568.
doi: 10.1186/s12885-018-4478-3.

A systematic review of the risk factors for clinical response to opioids for all-age patients with cancer-related pain and presentation of the paediatric STOP pain study

Ersilia Lucenteforte  1   2 , Laura Vagnoli  3 , Alessandra Pugi  4 , Giada Crescioli  1 , Niccolò Lombardi  1 , Roberto Bonaiuti  1 , Maurizio Aricò  5 , Sabrina Giglio  6   7 , Andrea Messeri  3 , Alessandro Mugelli  1 , Alfredo Vannacci  1 , Valentina Maggini  8   9
Affiliations

A systematic review of the risk factors for clinical response to opioids for all-age patients with cancer-related pain and presentation of the paediatric STOP pain study

Ersilia Lucenteforte et al. BMC Cancer. .

Abstract

Background: Inter-patient variability in response to opioids is well known but a comprehensive definition of its pathophysiological mechanism is still lacking and, more importantly, no studies have focused on children. The STOP Pain project aimed to evaluate the risk factors that contribute to clinical response and adverse drug reactions to opioids by means of a systematic review and a clinical investigation on paediatric oncological patients.

Methods: We conducted a systematic literature search in EMBASE and PubMed up to the 24th of November 2016 following Cochrane Handbook and PRISMA guidelines. Two independent reviewers screened titles and abstracts along with full-text papers; disagreements were resolved by discussion with two other independent reviewers. We used a data extraction form to provide details of the included studies, and conducted quality assessment using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results: Young age, lung or gastrointestinal cancer, neuropathic or breakthrough pain and anxiety or sleep disturbance were associated to a worse response to opioid analgesia. No clear association was identified in literature regarding gender, ethnicity, weight, presence of metastases, biochemical or hematological factors. Studies in children were lacking. Between June 2011 and April 2014, the Italian STOP Pain project enrolled 87 paediatric cancer patients under treatment with opioids (morphine, codeine, oxycodone, fentanyl and tramadol).

Conclusions: Future studies on cancer pain should be designed with consideration for the highlighted factors to enhance our understanding of opioid non-response and safety. Studies in children are mandatory.

Trial registration: CRD42017057740 .

Keywords: Cancer pain; Children; Opioid efficacy; Opioid safety.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The STOP Pain study obtained ethics approval from the institutional review board of Meyer Children’s Hospital (Protocol letter 9116/2010, December 14, 2010). Written informed consent to participate in the study was obtained from each patient (or their parent or legal guardian).

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
PRISMA Flow diagram
See this image and copyright information in PMC

References

    1. Ferlay JBF, Pisani P, Parkin DM. GLOBOCAN 2002: Cancer incidence. 2004.
    1. Hechler T, Wager J, Zernikow B. Chronic pain treatment in children and adolescents: less is good, more is sometimes better. BMC Pediatr. 2014;14:262. doi: 10.1186/1471-2431-14-262. - DOI - PMC - PubMed
    1. Zernikow B, Hasan C, Hechler T, Huebner B, Gordon D, Michel E. Stop the pain! A nation-wide quality improvement programme in paediatric oncology pain control. Eur J Pain. 2008;12(7):819–833. doi: 10.1016/j.ejpain.2007.12.002. - DOI - PubMed
    1. Mercadante S, Giarratano A. Pharmacological management of cancer pain in children. Crit Rev Oncol Hematol. 2014;91(1):93–97. doi: 10.1016/j.critrevonc.2014.01.005. - DOI - PubMed
    1. World Health Organization. Cancer pain relief and palliative care in children. Geneva: World Health Organization; 1998. http://www.who.int/iris/handle/10665/42001. Accessed 23 Apr 2018.

Publication types

Substances

LinkOut - more resources