Effect of hyperthermia combined with opioids on cancer pain control and surgical stress in patients with gastrointestinal cancer

• Published in: World journal of gastrointestinal surgery 2024-12, Vol.16 (12), p.3745-3753
• Main Authors: Qian, Jing, Wu, Jing, Zhu, Jing, Qiu, Jie, Wu, Chuan-Fu, Hu, Cheng-Ru
• Format: Article
• Language: English
• Subjects: Retrospective Study
• ISSN: 1948-9366; 1948-9366
• DOI: 10.4240/wjgs.v16.i12.3745

Surgical palliative surgery is a common method for treating patients with middle and late stage gastrointestinal tumors. However, these patients generally experience high levels of cancer pain, which can in turn stimulate the body's stress and undermine the effect of external surgery. Although opioid drugs have a significantly positive effect on controlling cancer pain, they can induce adverse drug reactions and potential damage to the body 's immune function. Hyperthermia therapy produces a thermal effect that shrinks tumor tissues. However, its effect on relieving the pain of middle and late stage gastrointestinal tumors but also the stress of surgical palliative surgery remains unclear. To investigate the effect of hyperthermia combined with opioids on controlling cancer pain in patients with middle and late stage gastrointestinal cancer and evaluate its impact on surgical palliative surgical stress. This was a retrospective study using the data of 70 patients with middle and late stage gastrointestinal tumors who underwent cancer pain treatment and surgical palliative surgery in the Ninth People 's Hospital of Suzhou, China from January 2021 to June 2024. Patients were grouped according to different cancer pain control regimens before surgical palliative surgery, with = 35 cases in each group, as follows: Patients who solely used opioid drugs to control cancer pain were included in Group S, while patients who received hyperthermia treatment combined with opioid drugs were included in Group L. In both groups, we compared the effectiveness of cancer pain control (pain score, burst pain score, 24-hour burst pain frequency, immune function, daily dosage of opioid drugs, and adverse reactions), surgical palliative indicators (surgery time, intraoperative bleeding, stress response), and postoperative recovery time, including first oral feeding time, postoperative hospital stay). Analgesic treatment resulted in a significant decrease in the average pain score, burst pain score, and 24-hour burst pain frequency in both Groups L and S; however, these scores were statistically significantly lower in Group L than in Group S group ( < 0.001). Analgesic treatment also resulted in significant differences, namely serum CD4 (29.18 ± 5.64 26.05 ± 4.76, = 0.014), CD8 (26.28 ± 3.75 29.23 ± 3.89, = 0.002), CD4 /CD8 (0.97 ± 0.12 0.83 ± 0.17, < 0.001), between Group L and Group S, respectively. The daily dosage of opioid drugs incidence of adverse reactions such as nausea,