AB63. Clinical characteristics and opioid treatment for pain of advanced gastric carcinoma

Objective: Gastric carcinoma is one of the most common malignant tumor in our country. Most patients were on the terminal stage when they were diagnosed. Palliative treatment is the main method of the advanced gastric carcinoma. It is important that good control of the pain should be attached importance to in order to improve the QOL of the patients.

Methods: 15 cases of gastric carcinoma with pain have been treated from Jan 2011 to Feb 2013 in our department. 13 cases were male and 2 cases were female. The average age was 66.5 years old. 14 cases were adenocarcinoma and 1 case was mucinous adenocarcinoma. The tumor located in stomach (6 cases) or cardia-fundus (5 cases) or antrum (3 cases) or gastric-remnant (1 case). All the patients were in stage IV when they went to the hospital.

Results: 9 cases had pain in upper abdomen. 2cases had pain in lower abdomen. 4 cases had pain in back, waist or lumbodorsal potion. The other 2 cases had pain in legs. 9 cases of severe pain were administrated with strong opioids; 4 cases had moderate pain, and were administrated with weak opioids; 2 cases that had mild pain were treated with NSAIDS. 2 cases of moderate pain changed to Durogesic patch, and 5 cases convered to and 1 case directly used Durogesic patch in patients with severe pain. All the patients controlled their pain under 3 degree (NRS).

Conclusions: The most common pain location of gastric carcinoma is upper abdomen. The most typical pain is visceral pain. The treatment still follows the WHO three ladder analgesic principles. The clinical characteristics of using opioids are low proportion of oral and high proportion of transdermal patch.

Keywords: Gastric carcinoma; pain; opioid