Effectiveness of fentanyl pectin nasal citrate in controlling episodes of breakthrough cancer pain triggered by routine radiotherapy procedures

• Published in: Clinical & translational oncology 2019-11, Vol.21 (11), p.1568-1572
• Main Authors: Pardo, J., Mena, A., Jiménez, E., Aymar, N., Ortiz, I., Roncero, R., Mestre, F., Vidal, M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analgesics, Opioid - administration & dosage; Breakthrough Pain - drug therapy; Breakthrough Pain - etiology; Cancer Pain - drug therapy; Cancer Pain - etiology; Female; Fentanyl - administration & dosage; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nasal Sprays; Neoplasms - radiotherapy; Oncology; Pain Measurement; Pain, Procedural - complications; Pain, Procedural - drug therapy; Radiotherapy - adverse effects; Research Article
• ISSN: 1699-048X; 1699-3055
• DOI: 10.1007/s12094-019-02125-8

Purpose The aim of the study was to evaluate the effectiveness of fentanyl pectin nasal spray (FPNS) in controlling procedural breakthrough cancer pain (BTCP) in advanced cancer patients undergoing radiotherapy. Materials and methods This study involved 62 advanced cancer patients, with well-controlled background pain, who presented BTCP associated to routine radiotherapy procedures, treated with FPNS according to our protocol of administration. The BPE intensity was measured using a visual analog scale (VAS). Results The BTCP was triggered during the computed tomography simulation (79.3%) or treatment delivery (20.7%). Patients indicated a mean VAS of 8.8 (range 7–10) when attempting the procedure. After 4.5 min (range 2–10) of the first FPNS dose, the majority of patients (85.5%) indicated a VAS of 4.3 (range 2–6). 15.5% of the patients did not respond after 15 min; requiring a second dose. All these patients responded, reporting a mean VAS of 4.2 (range 4–6) after 3.0 min (range 2–5) of the second dose. None of the patients required a third dose, nor reported an AE after the administration of FPNS. Conclusions In our knowledge, our study is the one of highest recruitment, and with the fastest response of BTCP treated with FPNS reported in advanced cancer patients undergoing radiotherapy. FPNS has proven to be highly effective in reducing the intensity of procedural BTCP in a very short period of time.