Seminars in Oncology
Volume 32, Issue 2 , Pages 179-193 , April 2005

Management of cancer pain

  • Michael H. Levy

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Michael H. Levy, MD, PhD, Department of Medical Oncology, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA 19111
    • ,
  • Thomas A. Samuel

References 

  1. Jemal A , Murray T , Ward E , et al.   Cancer statistics, 2005 . CA Cancer J Clin . 2005;55:10–30
  2. Cleeland CS , Gonin R , Hatfield AK , et al.   Pain and its treatment in outpatients with metastatic cancer . N Engl J Med . 1994;330:592–596
  3. Foley KM , Gelband H . Improving Palliative Care for Cancer (Summary and Recommendations) . Washington, DC: Academic Press; 2001;
  4. Jacox A , Carr DB , Payne R . Management of Cancer Pain (Clinical Practice Guideline. No. 9 (AHCPR publication no. 94–0592)) . Rockville, MD: Agency for Health Care Policy and Research; 1994;
  5. Miaskowski C , Cleary J , Burney R . Guideline for the Management of Cancer Pain in Adults and Children, APS Clinical Practice Guidelines Series, No. 3 . Glenview, IL: American Pain Society; 2005;
  6. In:  Sykes N ,  Fallon M ,  Patt R editor. Clinical Pain Management (Cancer Pain) . New York, NY: Oxford University Press; 2003;
  7. Grond S , Zech D , Diefenbach C , et al.   Prevalence and pattern of symptoms in patients with cancer pain (A prospective evaluation of 1635 cancer patients referred to a pain clinic) . J Pain Symptom Manage . 1994;9:372–382
  8. Coyle N , Adelhardt J , Foley KM , et al.   Character of terminal illness in the advanced cancer patient (Pain and other symptoms during the last four weeks of life) . J Pain Symptom Manage . 1990;5:83–93
  9. Levy MH . Integration of pain management into comprehensive cancer care . Cancer . 1989;63(suppl):2328–2335
  10. Kim P . Interventional cancer pain therapies . Semin Oncol . 2005;32:194–199
  11. Levy MH , Cohen SC . Sedation for the relief of refractory symptoms (A fine intentional line) . Semin Oncol . 2005;32:237–246
  12. Rousseau P . Palliative sedation in the management of refractory symptoms . J Support Oncol . 2004;2:181–186
  13. Cherny NI . In: The Use of Sedation in the Management of Refractory Pain. Principles and Practices of Supportive Oncology Update, vol. 3 . New York, NY: Lippincott Williams & Wilkins; 2000;p. 1–11
  14. Cowan JD , Walsh D . Terminal sedation in palliative medicine—Definition and review of the literature . Support Care Cancer . 2001;9:403–407
  15. Snyder L , Sulmasy DP . Physician-assisted suicide . Ann Intern Med . 2001;135:209–216
  16. Ballantyne JC . Chronic pain following treatment for cancer (The role of opioids) . Oncologist . 2003;8:567–575
  17. Cherny NI . The pharmacologic management of cancer pain . Oncology . 2004;18:1499–1515
  18. Levy MH . Pharmacologic management of cancer pain . Semin Oncol . 1994;21:718–739
  19. Levy MH . Pharmacologic treatment of cancer pain . N Engl J Med . 1996;335:1124–1132
  20. In: Principles of Analgesic Use in the Treatment of Acute Pain and Chronic Cancer Pain . Ed. 5. Glenview, IL: American Pain Society; 2003;
  21. In:  Doyle D ,  Hanks GWC ,  MacDonald N editor. Oxford Textbook of Palliative Medicine . (ed 3). Oxford, England: Oxford University Press; 2003;
  22. In:  Berger A ,  Portenoy RP ,  Weisman D editor. Principles and Practice of Palliative Care and Supportive Oncology . Philadelphia, PA: Lippincott-Raven; 2002;
  23. Turk DC , Monarch ES , Williams AD . Cancer patients in pain (Considerations for assessing the whole person) . Hematol Oncol Clin North Am . 2002;16:511–525
  24. Serlin RC , Mendoza TR , Nakamura Y , et al.   When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function . Pain . 1995;61:277–284
  25. Caraceni A , Portenoy RK . An international survey of cancer pain characteristics and syndromes . Pain . 1999;82:263–274
  26. Eisenberg E . Post-surgical neuralgia . Pain . 2004;111:3–7
  27. Bartusch SL , Sanders BJ , D’Alessio JG , et al.   Clonazepam for the treatment of lancinating phantom limb pain . Clin J Pain . 1996;12:59–62
  28. Zaza C , Baine N . Cancer pain and psychosocial factors (A critical review of the literature) . J Pain Symptom Manage . 2002;24:526–542
  29. Passik SD , Portenoy FK , Ricketts PL . Substance abuse issues in cancer patients . Oncology . 1998;12:517–521
  30. Cancer Pain Guideline Panel. Cancer Pain Guidelines, Version 1.2004. Philadelphia, PA. National Comprehensive Cancer Network, [www.nccn.org], 2004
  31. Savage S, Covington E, Heit H, et al: Definitions related to the use of opioids for the treatment of pain: A consensus document from the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine. Glenview, IL, 2001
  32. Ballantyne JC , Mao J . Opioid therapy for chronic pain . N Engl J Med . 2003;349:1943–1953
  33. Gilson AM , Ryan KM , Joranson DE . A reassessment of trends in the medical use and abuse of opioid analgesics and the implications for diversion control (1997–2002) . J Pain Symptom Manage . 2004;28:176–188
  34. Passik SD , Kirsh KL , Whitcomb L , et al.   Pain clinicians’ rankings of aberrant drug-taking behaviors . J Pain Palliat Care Pharmacother . 2002;16:39–49
  35. McNicol E , Strassels S , Goudas L , et al.   Nonsteroidal anti-inflammatory drugs, alone or combined with opioids, for cancer pain (A systematic review) . J Clin Oncol . 2004;22:1975–1992
  36. Makin AJ , Wendon J , Williams R . A 7-year experience of severe acetaminophen-induced hepatotoxicity (1987–1993) . Gastroenterology . 1995;109:1907–1916
  37. Schiodt FV , Rochling FA , Casey DL , et al.   Acetaminophen toxicity in an urban county hospital . N Engl J Med . 1997;337:1112–1117
  38. Simon L , Jacox A , Caudill-Slosberg M . Guideline for the Management of Pain in Osteoarthritis, Rheumatoid Arthritis, and Juvenile Chronic Arthritis . Glenview, IL: American Pain Society; 2002;
  39. Valentini M , Cannizzaro R , Poletti M , et al.   Non-steroidal anti-inflammatory drugs for cancer pain (comparison between misoprostol and ranitidine in prevention of upper gastrointestinal damage) . J Clin Oncol . 1995;13:2637–2642
  40. Graham D , Agrawal N , Campbell D , et al.   Ulcer prevention in long-term use of nonsteroidal anti-inflammatory drugs. Results of a double-blind, randomized, multice4nter, active- and placebo-controlled study of misoprostol vs. lansoprazole . Arch Intern Med . 2002;162:169–175
  41. Stuart JJ , Pisko EJ . Choline magnesium trisalicylate does not impair platelet aggregation . Pharmacotherapeutics . 1981;2:547–551
  42. Johnson JR , Miller AJ . The efficacy of choline magnesium trisalicylate (CMT) in the management of metastatic bone pain (A pilot study) . Palliat Med . 1994;8:129–135
  43. Clark DW , Layton D , Shakir SA . Do some inhibitors of COX-2 increase the risk of thromboembolic events? Linking pharmacology with pharmacoepidemiology . Drug Saf . 2004;27:427–456
  44. US Food and Drug Administration: Public Health Advisory. Non-steroidal Anti-inflammatory Drug Products (NSAIDS). DA/Center for Drug Evaluation and Research. Rockville, MD, [www.fda.gov/cder], December 23, 2004
  45. Solomon DH , Schneeweis S , Glynn RJ , et al.   Relationship between selective cyclo-oxygenase-2 inhibitors and acute myocardial infarction in older adults . Circulation . 2004;109:2068–2073
  46. White WB , Faich G , Borer JS , et al.   Cardiovascular thrombotic events in arthritis trials of cyclo-oxygenase-2 inhibitor Celecoxib . Am J Cardiol . 2003;92:411–418
  47. Sunshine A . New clinical experience with tramadol . Drugs . 1994;47(suppl 1):8–18
  48. Wilder-Smith CH , Schimke J , Osterwalder B , et al.   Oral tramadol, a mu-opioid agonist and monoamine reuptake-blocker, and morphine for strong cancer-related pain . Ann Oncol . 1994;5:141–146
  49. Stubhaug A , Grimstad J , Breivik H . Lack of analgesic effect of 50 and 100 mg oral tramadol after orthopedic surgery (A randomized, double-blind, placebo and standard active drug comparison) . Pain . 1995;62:111–118
  50. Desmeules J , Gascon M-P , Dayer P , et al.   Impact of environmental and genetic factors on codeine analgesia . Eur J Clin Pharmacol . 1991;41:23–26
  51. Sindrup SH , Arendt-Nielsen L , Brosen K , et al.   The effect of quinidine on the analgesic effect of codeine . Eur J Clin Pharmacol . 1992;42:587–591
  52. Galer BS , Coyle N , Pasternak GW , et al.   Individual variability in the response to different opioids (Report of five cases) . Pain . 1992;49:87–91
  53. MacDonald N , Der L , Allan S , Champion P . Opioid hyperexcitability (The application of alternate opioid therapy) . Pain . 1993;53:353–355
  54. de Stoutz ND , Bruera E , Suarez-Almazor M . Opioid rotation for toxicity reduction in terminal cancer patients . J Pain Symptom Manage . 1995;10:378–384
  55. Davis MP , Walsh D . Methadone for relief of cancer pain (A review of pharmacokinetics, pharmacodynamics, drug interactions, and protocols of administration) . Support Care Cancer . 2001;9:73–83
  56. Bruera E , Pereira J , Watanbe S , et al.   Opioid rotation in patients with cancer pain. A retrospective comparison of dose ratios between methadone, hydromorphone, and morphine . Cancer . 1996;78:852–857
  57. Bruera E , Palmer JL , Bosniak S , et al.   Methadone versus morphine as a first-line strong opioid for cancer pain (A randomized, double-blind study) . J Clin Oncol . 2004;22:185–192
  58. Finn JW , Walsh TD , MacDonald N , et al.   Placebo-blinded study of morphine sulfate sustained-release tablets and immediate-release morphine sulfate solution in outpatients with chronic pain due to advanced cancer . J Clin Oncol . 1993;11:967–972
  59. Kalso E , Vainio A . Morphine and oxycodone hydrochloride in the management of cancer pain . Clin Pharmacol Ther . 1990;47:639–646
  60. Glare PA , Walsh TD . Dose-ranging study of oxycodone for chronic pain in advanced cancer . J Clin Oncol . 1993;11:973–978
  61. Levy MH . Advancement of opioid analgesia with controlled-release oxycodone . Eur J Pain . 2001;5(suppl A):113–116
  62. Swanton R , Buckley B . Long-term efficacy and safety of once-daily oral extended-release hydromorphone . J Clin Pharmacol . 2002;22:1068; (abstr)
  63. Wright C , Shi MG , Colonnese C . Efficacy and safety of an oral 24-hour extended-release hydromorphone formulation for the relief of persistent nonmalignant pain . Pain Med . 2004;5:115; (abstr)
  64. Roy SD , Flynn GL . Solubility and related physicochemical properties of narcotic analgesics . Pharm Res . 1988;5:580–586
  65. OxyContin . Its Use and Abuse. Hearing before the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce, House of Representatives, August 28, 2001. . Washington, DC: US Government Printing Office; 2001; Serial No. 107–54
  66. Davis MP , Varga J , Dickerson D , et al.   Normal-release and controlled-release oxycodone (Pharmacokinetics, pharmacodynamics, and controversy) . Support Care Cancer . 2003;11:84–92
  67. Donner B , Zenz M , Tryba M , et al.   Direct conversion from oral morphine to transdermal fentanyl (A multicenter study in patients with cancer pain) . Pain . 1996;64:527–534
  68. Ahmedzai S , Brooks D . Transdermal fentanyl versus sustained-release oral morphine in cancer pain (Preference, efficacy, and quality of life. The TTS-Fentanyl Comparative Trial Group) . J Pain Symptom Manage . 1997;13:254–261
  69. Payne R . Factors influencing quality of life in cancer patients (The role of transdermal fentanyl in the management of pain) . Semin Oncol . 1998;25(suppl 7):47–53
  70. Kornick CA , Santiago-Palma J , Khojainova N , et al.   A safe and effective method for converting cancer patients from intravenous to transdermal fentanyl . Cancer . 2001;92:3056–3061
  71. Streisand JB , Busch MA , Egan TD , et al.   Dose proportionality and pharmacokinetics of oral transmucosal fentanyl citrate . Anesthesiology . 1998;88:305–309
  72. Christie JM , Simmonds M , Patt R , et al.   Dose-titration, multicenter study of oral transmucosal fentanyl citrate for the treatment of breakthrough pain in cancer patients using transdermal fentanyl for persistent pain . J Clin Oncol . 1998;16:3238–3245
  73. Portenoy RK , Payne R , Coluzzi P , et al.   Oral transmucosal fentanyl citrate (OFTC) for the treatment of break through pain in cancer patients (A controlled dose titration study) . Pain . 1999;79:303–312
  74. Brescia FJ , Portenoy RK , Ryan M , et al.   Pain, opioid use, and survival in hospitalized patients with advanced cancer . J Clin Oncol . 1992;10:149–155
  75. Foley KM . Changing Concepts of tolerance to opioids (What the cancer patient has taught us) . In:  Chapman CR ,  Foley K editor. Current and Emerging Issues in Cancer Pain (Research and Practice) . New York, NY: Raven; 1993;p. 331–350
  76. Ferrell BR , Griffith H . Cost issues related to pain management (Report from the Cancer Pain Panel of the Agency for Health Care Policy and Research) . J Pain Symptom Manage . 1994;9:221–234
  77. Davis MP , Walsh D , LeGrand SB . Symptom control in cancer patients (The clinical pharmacology and therapeutic role of suppositories and rectal suspensions) . Support Care Cancer . 2002;10:117–138
  78. Broomhead A , Kerr R , Tester W , et al.   Comparison of a once-a-day sustained-release morphine formulation with standard oral morphine treatment for cancer pain . J Pain Symptom Manage . 1997;14:63–73
  79. Broomhead A , West R , Kadirgamanathan G , et al.   Comparative bioavailability of sustained-release morphine sulfate capsules versus pellets . Clin Drug Invest . 1997;14:137–145
  80. Eliot L , Butler J , Davane J , et al.   Pharmacokinetic evaluation of a sprinkle-dose regimen of a once-daily, extended-release morphine formulation . Clin Ther . 2002;24:260–268
  81. Portenoy RK , Sciberras A , Eliot L , et al.   Steady-state pharmacokinetic comparison of a new, extended-release, once-daily morphine formulation, Avinza, and a twice-daily controlled-release morphine formulation in patients with chronic moderate-to-severe pain . J Pain Symptom Manage . 2002;23:292–300
  82. Kerr IG , Sone M , Deangelis D , et al.   Continuous narcotic infusion with patient-controlled analgesia for chronic cancer pain in outpatients . Ann Intern Med . 1988;188:554–557
  83. Coyle N , Cherny NI , Portenoy RK . Subcutaneous opioid infusions at home . Oncology . 1994;8:21–27
  84. Moulin DE , Kreeft JH , Murray-Parsons N , et al.   Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain . Lancet . 1991;337:465–468
  85. Bennett G , Burchiel K , Buchser E , et al.   Clinical guidelines for intraspinal infusion: Report of an expert panel. PolyAnalgesic Consensus Conference . J Pain Symptom Manage . 2000;20:S37–S43
  86. Smith TJ , Staats PS , Deer T , et al.   Randomized clinical trial of an implantable drug delivery system compared with comprehensive medical management for refractory cancer pain (Impact on pain, drug-related toxicity, and survival) . J Clin Oncol . 2002;20:4040–4049
  87. Walker SM , Goudas LC , Cousins MJ , et al.   Combination spinal analgesic chemotherapy (A systemic review) . Anesth Analg . 2002;95:674–715
  88. Ackerman LL , Follett KA , Rosenquist RW . Long term outcomes during treatment of chronic pain with intrathecal clonidine or clonidine/opioid combinations . J Pain Symptom Manage . 2003;26:668–677
  89. Staats PS , Yearwood T , Charapata SG , et al.   Intrathecal ziconotide in the treatment of refractory pain in patients with cancer or AIDS. A randomized controlled trial . JAMA . 2003;291:63–70
  90. Cherny N , Ripamonti C , Pereira J , et al.   Strategies to manage the adverse effects of oral morphine (An evidence-based report) . J Clin Oncol . 2001;19:2542–2554
  91. Levy MH . Management of opioid-induced bowel dysfunction . J Natl Compr Cancer Network . 2003;1(suppl 3):S22–S26
  92. McNicol E , Horowicz-Mehler N , Fisk RA , et al.   Management of opioid side-effects in cancer-related and chronic non-cancer pain (A systematic review) . J Pain . 2003;4:231–256
  93. Herndon CM , Jackson KC , Hallin PA . Management of opioid-induced gastrointestinal effects in patients receiving palliative care . Pharmacotherapy . 2002;22:240–250
  94. Wilwerding MB , Loprinzi CL , Mailliard MA , et al.   A randomized, crossover evaluation of methylphenidate in cancer patients receiving strong narcotics . Support Care Cancer . 1995;3:135–138
  95. Sawynok J , Yaksh TL . Caffeine as an analgesic adjuvant (A review of pharmacology and mechanisms of action) . Pharmacol Rev . 1993;45:43–85
  96. Webster L . Modafanil treatment of opioid-induced sedation . Pain Med . 2003;4:135–140
  97. Eisele JH , Grigsby EJ , Dea G . Clonazepam treatment of myoclonic contractions associated with high-dose opioids (Case report) . Pain . 1992;49:231–232
  98. Davis AM , Inturrisi CE . d-Methadone blocks morphine tolerance and N-methyl-D-aspartate-induced hyperalgesia . J Pharmacol Exp Ther . 1999;289:1048–1053
  99. DeConno F , Groff L , Brunelli D , et al.   Clinical experience with oral methadone administration in the treatment of pain in 196 advanced cancer patients . J Clin Oncol . 1996;14:2836–2842
  100. Lussier D , Huskey AG , Portenoy RK . Adjuvant analgesics in cancer pain management . Oncologist . 2004;9:571–591
  101. Watanabe S , Bruera E . Corticosteroids as adjuvant analgesics . J Pain Symptom Manage . 1994;9:442–445
  102. Mercadante S , Fulfaro F , Casuccio A . The use of corticosteroids in home palliative care . Support Care Cancer . 2001;9:386–389
  103. Watson CP . The treatment of neuropathic pain (Antidepressants and opioids) . Clin J Pain . 2000;16(suppl 2):49–55
  104. McQuay HJ , Tramer M , Nye BA , et al.   A systematic review of antidepressants in neuropathic pain . Pain . 1996;68:217–227
  105. Dworkin RH , Backonja M , Rowbotham MC , et al.   Advances in neuropathic pain (Diagnosis, mechanisms, and treatment recommendations) . Arch Neurol . 2003;60:1524–1534
  106. Rasmussen PV , Jensen TS , Sindrup SH , et al.   TDM-based imipramine treatment in neuropathic pain . Ther Drug Monit . 2004;26:352–360
  107. Max MB , Lynch SA , Muir J , et al.   Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy . N Engl J Med . 1992;326:1250–1256
  108. Tasmuth T , Hartel B , Kalso E . Venlafaxine in neuropathic pain following treatment of breast cancer . Eur J Pain . 2002;6:17–24
  109. Sindrup SH , Bach FRW , Madsen C , et al.   Venlafaxine versus imipramine in painful polyneuropathy. A randomized controlled trial . Neurology . 2003;60:1284–1289
  110. Fava M , Mallinckrodt CH , Detke MJ , et al.   The effect of duloxetine on painful physical symptoms in depressed patients (Do improvements in these symptoms result in higher remission rates?) . J Clin Psychiatry . 2004;65:521–531
  111. Bennett MI , Simpson KH . Gabapentin in the treatment of neuropathic pain . Palliat Med . 2004;18:5–11
  112. Chong MS , Bajwa ZH . Diagnosis and treatment of neuropathic pain . J Pain Symptom Manage . 2003;25(suppl):4–11
  113. Namaka M , Gramlich CR , Ruhlen D , et al.   A treatment algorithm for neuropathic pain . Clin Ther . 2004;26:951–979
  114. Backonja MM . Anticonvulsants (antineuropathics) for neuropathic pain syndromes . Clin J Pain . 2000;16(suppl 2):67–72
  115. Dejgard A , Petersen P , Kastrup J . Mexiletine for treatment of chronic painful diabetic neuropathy . Lancet . 1988;1:9–11
  116. Chabal C , Jacobson L , Mariano A , et al.   The use of oral mexiletine for the treatment of pain after peripheral nerve injury . Anesthesiology . 1992;76:513–517
  117. Tanelian DL , Victory RA . Sodium channel-blocking agents (their use in neuropathic pain conditions) . Pain Forum . 1995;4:75–80
  118. Sloan P , Basta M , Storey P , et al.   Mexiletine as an adjuvant analgesic for the management of neuropathic cancer pain . Anesth Analg . 1999;89:760–761
  119. Galer BS , Rowbotham MC , Perander J , et al.   Topical lidocaine patch relieves postherpetic neuralgia more effectively than a vehicle topical patch (Results of an enriched enrollment study) . Pain . 1999;80:533–538
  120. Gammaitoni AR , Alvarez NA , Galer BS . Safety and tolerability of lidocaine patch 5%, a targeted peripheral analgesic (A review of the literature) . J Clin Pharmacol . 2003;43:111–117
  121. Fromm GH . Baclofen as an adjuvant analgesic . J Pain Symptom Manage . 1994;9:500–509
  122. Harner JP , Larson B . Pain relief from Baclofen analgesia in neuropathic pain patients who failed opioid pharmacotherapy (Case report) . J Pain Palliat Care Pharmacother . 2002;16:61–64
  123. Chong MS , Libretto SE . The rationale and use of topiramate for treating neuropathic pain . Clin J Pain . 2003;19:59–69
  124. Schmid RL , Sandler AN , Katz A . Use and efficacy of low-dose ketamine in the management of acute postoperative pain (A review of current techniques and outcomes) . Pain . 1999;82:111–125
  125. Fitzgibbon EJ , Hall P , Schroeder C , et al.   Low dose ketamine as an analgesic adjuvant in difficult pain syndromes (A strategy for conversion from parenteral to oral ketamine) . J Pain Symptom Manage . 2002;23:165–170
  126. Bell RF , Eccleston C , Kalso E . Ketamine as adjuvant to opioids for cancer pain. A qualitative systemic review . J Pain Symptom Manage . 2003;26:867–875
  127. Bloomfield DJ . Should bisphosphonates be part of the standard therapy of patients with multiple myeloma or bone metastases from other cancers? An evidence-based review . J Clin Oncol . 1998;16:1218–1225
  128. Theiriault RL , Lipton A , Hortabagyi GN , et al.   Pamidronate reduces skeletal morbidity in women with advanced breast cancer and lytic bone lesions (A randomized, placebo-controlled trial) . J Clin Oncol . 1999;17:846–854
  129. Saad F , Gleason DM , Murray R , et al.   A randomized, placebo-controlled trial of zoledronic acid in patients with hormone-refractory metastatic prostate carcinoma . J Natl Cancer Inst . 2002;94:1458–1468
  130. Rosen LS . Efficacy and safety of zoledronic acid in the treatment of bone metastases associated with lung cancer and other solid tumors . Semin Oncol . 2002;29(suppl 21):28–32
  131. Skerjanec A , Berenson J , Hsu C , et al.   The pharmacokinetics and pharmacodynamics of zoledronic acid in cancer patients with varying degrees of renal function . J Clin Pharmacol . 2003;43:154–162
  132. Gennari C , Chierchetti SM , Piolini M , et al.   Analgesic activity of salmon and human calcitonin against cancer pain (A double-blind, placebo-controlled clinical study) . Curr Ther Res . 1985;38:298–303
  133. Roth A , Kolaric K . Analgesic activity of calcitonin in patients with pain from osteolytic metastases of breast cancer . Oncology . 1986;43:283–287
  134. Jaeger H , Maier C . Calcitonin in phantom limb pain (a double-blind study) . Pain . 1992;48:21–27
  135. Szanto J , Ady N , Jozsef S . Pain killing with calcitonin nasal spray in patients with malignant tumors . Oncology . 1992;49:180–182
  136. Robinson RG , Preston DF , Schiefelbein M , et al.   Strontium-89 therapy for the palliation of pain due to osseous metastases . JAMA . 1995;274:420–424
  137. Rogers CL , Speiser BL , Ram PC , et al.   Efficacy and toxicity of intravenous strontinum-89 for symptomatic osseous metastases . J Brachyther Int . 1998;14:133–142
  138. Alberts AS , Smit BJ , Louw WKA , et al.   Dose response relationship and multiple dose efficacy and toxicity of samarium-153-EDTMP in metastatic cancer to bone . Radiother Oncol . 1997;43:175–179
  139. Serafine AN , Houston SJ , Resche I , et al.   Palliation of pain associated with metastatic bone cancer using samarium-153 lexidronam (A double-blind, placebo-controlled clinical trial) . J Clin Oncol . 1998;16:1574–1581
  140. Mercadante S , Ripamonti C , Casuccio A , et al.   Comparison of octreotide and hyoscine butylbromide in controlling gastrointestinal symptoms due to malignant inoperable bowel obstruction . Support Care Cancer . 2000;8:188–191
  141. Ripamonti C , Mercadante S , Gnoff I , et al.   Role of octreotide, scopolamine butylbromide, and hydration in symptom control of patients with inoperable bowel obstruction and nasogastric tubes (A prospective randomized trial) . J Pain Symptom Manage . 2000;19:23–34
  142. Jatoi A , Podratz KC , Gill P , et al.   Pathophysiology and palliation of inoperable bowel obstruction in patients with ovarian cancer . J Support Oncol . 2004;2:323–337
  143. Ripamonti C , Mercadante S . How to use octreotide for malignant bowel obstruction . J Support Oncol . 2004;2:357–364

PII: S0093-7754(05)00064-3

doi: 10.1053/j.seminoncol.2005.02.004

Seminars in Oncology
Volume 32, Issue 2 , Pages 179-193 , April 2005

Article Tools