Tramadol /Acetaminophen Fixed-Dose Combination (Ultracet) is as Effective as Fentanyl Transdermal System for Gynecologic Cancer Pain

Tramadol Hydrochloride/Acetaminophen固定劑型應用在婦科癌症病人癌症疼痛的緩解和經皮膚吸收的Fantanyl一樣有效

復發性婦科癌症病人，疼痛是一常見徵狀且需要進一步評估和處理。臨床上使用經皮膚吸收的Fantanyl貼片已成功的緩解癌症引起的疼痛。Tramadol hyfrochloride 75毫克和acetaminophen 325毫克組合（Ultracet）可提供快速和有效的止痛效果。本研究的目的是在比較Ultracet應用在婦科癌症病人癌症疼痛的緩解和經皮膚吸收的Fantanyl是否一樣有效。本研究屬回溯行研究，共收集40位中度至重度（（在10公分visual analog score量表中≧4公分）癌症疼痛無法使用NSAIDs或cyclooxygenase-2選擇性抑制劑達到緩解的復發性婦科癌症病人。他們之中有12位接受Ultracet，28位接受經皮膚吸收的Fantanyl貼片。藥物有效性最終判定是根據多少比率的病人達到疼痛強度改善的比例從基準線到最後評估超過百分之三十。結果發現治療前和治療後兩組病人疼痛強度改善比例超過百分之三十的比率是相似的（（83%vs89%，P>0.05）。我們得到結論Ultracet固定劑型應用在婦科癌症病人癌症疼痛的緩解和經皮膚吸收的Fantanyl一樣有效。

Objective: In recurrent gynecologic cancer patients, pain is a common condition need to be assessed and managed. Fentanyl transdermal patch has been used successfully to relieve cancer pain. The combination of tramadol hydrochloride 75mg and acetaminophen 325mg (Ultracet) has been shown to provide rapid and effective analgesic effects. The goal of this study was to compare the efficacy of Ultracet and fentanyl transdermal patch for the treatment of cancer pain in recurrent gynecologic cancer patients. Methods: A retrospective study conducted in Cathay General Hospital enrolled 40 recurrent gynecologic cancer patients with moderate to severe (≧4 cm on a 10 cm visual analog score) cancer pain insufficiently relieved by previous NSAIDs or cyclooxygenase-2 - selective inhibitors. They either received Ultracet (n=12) or fentanyl transdermal patch (n=28). The efficacy endpoint was the percentage of patients with a pain intensity change rate ≧30% from baseline to final evaluation. Results: The percentage of patients with a pain intensity change rate (≧ 30%) before and after treatment was similar in both Ultracet group and fentanyl transdermal patch group (83% vs 89%, P>0.05). Conclusion: Ultracet is as effective as fentanyl transdermal patch for the treatment of cancer pain in gynecologic cancer patients.