Pharmacological management for dyspnea in terminally ill cancer patients.

2022 Fiscal Year Final Research Report

• Project/Area Number: 18K15389
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52010:General internal medicine-related
• Research Institution: Kobe University
• Principal Investigator: Yamaguchi Takashi 神戸大学, 医学部附属病院, 特命教授 (10725394)
• Project Period (FY): 2018-04-01 – 2023-03-31
• Keywords: 呼吸困難 / 死前喘鳴 / がん / オピオイド / ベンゾジアゼピン / コルチコステロイド / 酸素療法 / 緩和ケア

Outline of Final Research Achievements

A survey study using a questionnaire on palliative treatment of dyspnea in cancer patients was conducted among palliative medicine specialists in Japan to determine their daily clinical attitudes toward opioids, benzodiazepines, steroids, and oxygen therapy as palliative treatment for dyspnea in cancer patients, as well as various palliative treatments for ante mortem wheezing. The study also clarified the concept in daily clinical practice of palliative care at 12 facilities in Japan.
In addition, a registry study of opioid therapy for symptomatic palliation of dyspnea in cancer patients undergoing intervention by palliative care services at 12 facilities nationwide was conducted, and using data accumulated from 402 cases, showed that dyspnea significantly improved in more than 80% of cases by 72 hours after the start of opioids.

Free Research Field

緩和医療

Academic Significance and Societal Importance of the Research Achievements

国内の緩和ケア専門家のがん患者の呼吸困難に対する各種症状緩和治療に関する認識を明らかにし、今後の観察研究ならびに介入研究を計画していくにあたっての基礎的なデータを得ることができた。また、がん患者の呼吸困難に対するオピオイド治療の観察研究により得られた結果から、通常診療におけるオピオイド治療の効果・有害事象の実態を明らかにでき、臨床現場で治療の意義や安全性に関して患者・家族に正確な情報提供を行うことにつながると考えられる。