Effects of Oral Morphine on Dyspnea in Patients with Cancer: Response Rate, Predictive Factors, and Clinically Meaningful Change (CJLSG1101)

Kosuke Takahashi, Masashi Kondo, Masahiko Ando, Akira Shiraki, Harunori Nakashima, Hisashi Wakayama, Kensuke Kataoka, Masashi Yamamoto, Yasuteru Sugino, Mitsunori Nishikawa, Kazuyoshi Imaizumi, Eiji Kojima, Atsushi Sumida, Yoshihiro Takeyama, Hiroshi Saito, Yoshinori Hasegawa

Research output: Contribution to journalArticle

Abstract

Background: Although the efficacy of parenteral morphine for alleviating dyspnea has been previously demonstrated in several studies, little is known regarding the efficacy of oral morphine for dyspnea among patients with cancer, including its response rate and predictive factors of effectiveness. Therefore, the aim of this study was to clarify the effectiveness of oral morphine on dyspnea in patients with cancer and elucidate the predictive factors of its effectiveness. Subjects, Materials, and Methods: In this multicenter prospective observational study, we investigated the change in dyspnea intensity in patients with cancer before and after the administration of oral morphine by using a visual analog scale (VAS). We also administered a self-assessment questionnaire to determine whether the patients believed oral morphine was effective. Results: Eighty patients were enrolled in the study, and 71 of these patients were eligible. The least square mean of the VAS scores for dyspnea intensity was 53.5 at baseline, which decreased significantly to 44.7, 40.8, and 35.0 at 30, 60, and 120 minutes after morphine administration, respectively. Fifty-four patients (76.1%) reported that oral morphine was effective on the self-assessment questionnaire. Among the background factors, a high score for “sense of discomfort” on the Cancer Dyspnea Scale (CDS) and a smoking history of fewer pack-years were associated with greater effectiveness. Conclusion: Oral morphine was effective and feasible for treating cancer-related dyspnea. A higher score for “sense of discomfort” on the CDS and a smaller cumulative amount of smoking may be predictive factors of the effectiveness of oral morphine. Implications for Practice: This study demonstrated that oral morphine was effective in alleviating cancer-related dyspnea due to multiple factors including primary lung lesions, airway narrowing, and pleural effusion. Approximately 76% of patients reported that oral morphine was effective. A higher score for “sense of discomfort” on the Cancer Dyspnea Scale and a lower cumulative amount of smoking may be predictive factors for the effectiveness of oral morphine. Interestingly, respiratory rates in patients who reported the morphine to be effective decreased significantly after oral morphine administration, unlike the respiratory rates in “morphine-ineffective” patients.

Original languageEnglish
Pages (from-to)e583-e589
JournalOncologist
Volume24
Issue number7
DOIs
Publication statusPublished - 01-07-2019

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Dyspnea
Morphine
Neoplasms
Smoking
Respiratory Rate
Visual Analog Scale
Oral Administration
Pleural Effusion
Least-Squares Analysis
Observational Studies
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Takahashi, Kosuke ; Kondo, Masashi ; Ando, Masahiko ; Shiraki, Akira ; Nakashima, Harunori ; Wakayama, Hisashi ; Kataoka, Kensuke ; Yamamoto, Masashi ; Sugino, Yasuteru ; Nishikawa, Mitsunori ; Imaizumi, Kazuyoshi ; Kojima, Eiji ; Sumida, Atsushi ; Takeyama, Yoshihiro ; Saito, Hiroshi ; Hasegawa, Yoshinori. / Effects of Oral Morphine on Dyspnea in Patients with Cancer : Response Rate, Predictive Factors, and Clinically Meaningful Change (CJLSG1101). In: Oncologist. 2019 ; Vol. 24, No. 7. pp. e583-e589.
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title = "Effects of Oral Morphine on Dyspnea in Patients with Cancer: Response Rate, Predictive Factors, and Clinically Meaningful Change (CJLSG1101)",
abstract = "Background: Although the efficacy of parenteral morphine for alleviating dyspnea has been previously demonstrated in several studies, little is known regarding the efficacy of oral morphine for dyspnea among patients with cancer, including its response rate and predictive factors of effectiveness. Therefore, the aim of this study was to clarify the effectiveness of oral morphine on dyspnea in patients with cancer and elucidate the predictive factors of its effectiveness. Subjects, Materials, and Methods: In this multicenter prospective observational study, we investigated the change in dyspnea intensity in patients with cancer before and after the administration of oral morphine by using a visual analog scale (VAS). We also administered a self-assessment questionnaire to determine whether the patients believed oral morphine was effective. Results: Eighty patients were enrolled in the study, and 71 of these patients were eligible. The least square mean of the VAS scores for dyspnea intensity was 53.5 at baseline, which decreased significantly to 44.7, 40.8, and 35.0 at 30, 60, and 120 minutes after morphine administration, respectively. Fifty-four patients (76.1{\%}) reported that oral morphine was effective on the self-assessment questionnaire. Among the background factors, a high score for “sense of discomfort” on the Cancer Dyspnea Scale (CDS) and a smoking history of fewer pack-years were associated with greater effectiveness. Conclusion: Oral morphine was effective and feasible for treating cancer-related dyspnea. A higher score for “sense of discomfort” on the CDS and a smaller cumulative amount of smoking may be predictive factors of the effectiveness of oral morphine. Implications for Practice: This study demonstrated that oral morphine was effective in alleviating cancer-related dyspnea due to multiple factors including primary lung lesions, airway narrowing, and pleural effusion. Approximately 76{\%} of patients reported that oral morphine was effective. A higher score for “sense of discomfort” on the Cancer Dyspnea Scale and a lower cumulative amount of smoking may be predictive factors for the effectiveness of oral morphine. Interestingly, respiratory rates in patients who reported the morphine to be effective decreased significantly after oral morphine administration, unlike the respiratory rates in “morphine-ineffective” patients.",
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Takahashi, K, Kondo, M, Ando, M, Shiraki, A, Nakashima, H, Wakayama, H, Kataoka, K, Yamamoto, M, Sugino, Y, Nishikawa, M, Imaizumi, K, Kojima, E, Sumida, A, Takeyama, Y, Saito, H & Hasegawa, Y 2019, 'Effects of Oral Morphine on Dyspnea in Patients with Cancer: Response Rate, Predictive Factors, and Clinically Meaningful Change (CJLSG1101)', Oncologist, vol. 24, no. 7, pp. e583-e589. https://doi.org/10.1634/theoncologist.2018-0468

Effects of Oral Morphine on Dyspnea in Patients with Cancer : Response Rate, Predictive Factors, and Clinically Meaningful Change (CJLSG1101). / Takahashi, Kosuke; Kondo, Masashi; Ando, Masahiko; Shiraki, Akira; Nakashima, Harunori; Wakayama, Hisashi; Kataoka, Kensuke; Yamamoto, Masashi; Sugino, Yasuteru; Nishikawa, Mitsunori; Imaizumi, Kazuyoshi; Kojima, Eiji; Sumida, Atsushi; Takeyama, Yoshihiro; Saito, Hiroshi; Hasegawa, Yoshinori.

In: Oncologist, Vol. 24, No. 7, 01.07.2019, p. e583-e589.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of Oral Morphine on Dyspnea in Patients with Cancer

T2 - Response Rate, Predictive Factors, and Clinically Meaningful Change (CJLSG1101)

AU - Takahashi, Kosuke

AU - Kondo, Masashi

AU - Ando, Masahiko

AU - Shiraki, Akira

AU - Nakashima, Harunori

AU - Wakayama, Hisashi

AU - Kataoka, Kensuke

AU - Yamamoto, Masashi

AU - Sugino, Yasuteru

AU - Nishikawa, Mitsunori

AU - Imaizumi, Kazuyoshi

AU - Kojima, Eiji

AU - Sumida, Atsushi

AU - Takeyama, Yoshihiro

AU - Saito, Hiroshi

AU - Hasegawa, Yoshinori

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Background: Although the efficacy of parenteral morphine for alleviating dyspnea has been previously demonstrated in several studies, little is known regarding the efficacy of oral morphine for dyspnea among patients with cancer, including its response rate and predictive factors of effectiveness. Therefore, the aim of this study was to clarify the effectiveness of oral morphine on dyspnea in patients with cancer and elucidate the predictive factors of its effectiveness. Subjects, Materials, and Methods: In this multicenter prospective observational study, we investigated the change in dyspnea intensity in patients with cancer before and after the administration of oral morphine by using a visual analog scale (VAS). We also administered a self-assessment questionnaire to determine whether the patients believed oral morphine was effective. Results: Eighty patients were enrolled in the study, and 71 of these patients were eligible. The least square mean of the VAS scores for dyspnea intensity was 53.5 at baseline, which decreased significantly to 44.7, 40.8, and 35.0 at 30, 60, and 120 minutes after morphine administration, respectively. Fifty-four patients (76.1%) reported that oral morphine was effective on the self-assessment questionnaire. Among the background factors, a high score for “sense of discomfort” on the Cancer Dyspnea Scale (CDS) and a smoking history of fewer pack-years were associated with greater effectiveness. Conclusion: Oral morphine was effective and feasible for treating cancer-related dyspnea. A higher score for “sense of discomfort” on the CDS and a smaller cumulative amount of smoking may be predictive factors of the effectiveness of oral morphine. Implications for Practice: This study demonstrated that oral morphine was effective in alleviating cancer-related dyspnea due to multiple factors including primary lung lesions, airway narrowing, and pleural effusion. Approximately 76% of patients reported that oral morphine was effective. A higher score for “sense of discomfort” on the Cancer Dyspnea Scale and a lower cumulative amount of smoking may be predictive factors for the effectiveness of oral morphine. Interestingly, respiratory rates in patients who reported the morphine to be effective decreased significantly after oral morphine administration, unlike the respiratory rates in “morphine-ineffective” patients.

AB - Background: Although the efficacy of parenteral morphine for alleviating dyspnea has been previously demonstrated in several studies, little is known regarding the efficacy of oral morphine for dyspnea among patients with cancer, including its response rate and predictive factors of effectiveness. Therefore, the aim of this study was to clarify the effectiveness of oral morphine on dyspnea in patients with cancer and elucidate the predictive factors of its effectiveness. Subjects, Materials, and Methods: In this multicenter prospective observational study, we investigated the change in dyspnea intensity in patients with cancer before and after the administration of oral morphine by using a visual analog scale (VAS). We also administered a self-assessment questionnaire to determine whether the patients believed oral morphine was effective. Results: Eighty patients were enrolled in the study, and 71 of these patients were eligible. The least square mean of the VAS scores for dyspnea intensity was 53.5 at baseline, which decreased significantly to 44.7, 40.8, and 35.0 at 30, 60, and 120 minutes after morphine administration, respectively. Fifty-four patients (76.1%) reported that oral morphine was effective on the self-assessment questionnaire. Among the background factors, a high score for “sense of discomfort” on the Cancer Dyspnea Scale (CDS) and a smoking history of fewer pack-years were associated with greater effectiveness. Conclusion: Oral morphine was effective and feasible for treating cancer-related dyspnea. A higher score for “sense of discomfort” on the CDS and a smaller cumulative amount of smoking may be predictive factors of the effectiveness of oral morphine. Implications for Practice: This study demonstrated that oral morphine was effective in alleviating cancer-related dyspnea due to multiple factors including primary lung lesions, airway narrowing, and pleural effusion. Approximately 76% of patients reported that oral morphine was effective. A higher score for “sense of discomfort” on the Cancer Dyspnea Scale and a lower cumulative amount of smoking may be predictive factors for the effectiveness of oral morphine. Interestingly, respiratory rates in patients who reported the morphine to be effective decreased significantly after oral morphine administration, unlike the respiratory rates in “morphine-ineffective” patients.

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