Evaluation of strong opioids on quality of life in patients with moderate cancer pain

Objective To compare the efficacy of WHO's three-step analgesic principle and cross-step application of strong opioids on moderate cancer pain and to evaluate their influence on quality of life in cancer patients. Methods A total of 60 patients with moderate cancer pain defined by Numerical Rating Scale (NRS) were randomly divided into a study group and a control group (n=30 each). The study group was treated with strong opioids, while the control group was treated with the second-step medication according to the WHO three-step analgesic principle. The analgesic efficacy of these two therapies were compared, and quality of life was evaluated by the the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 quality of life scale and the Karnofsky Performance Status (KPS) score. Results After treatment, The NRS scores of two groups were both significantly lower than those before treatment (P<0.05). The score of the study group decreased significantly than that of the control group (P<0.05). The KPS scores of two groups were both significantly higher than those before treatment (P<0.05). The efficacy of the study group was superior to that of the control group (P<0.05). EORTC QLQ-C30 Quality of Life Scale showed that the scores of physical, role, emotional, social, and cognitive function and overall quality of life of functional sub-scale after treatment were improved compared with those before treatment. After treatment, the scores of role function, emotional function and overall quality of life in the study group were higher than those in the control group (P<0.05). The pain and sleep scores of the two groups decreased after treatment, and the pain scores of the treatment group were lower than those of the control group (P<0.05). There was no significant difference in the sleep scores between the two groups (P＞0.05). After treatment, the symptoms of constipation in both groups were worse than those before treatment, but there was no significant difference (P＞0.05). Conclusions Early application of strong opioids is better than the application of weak opioids in the treatment of cancer pain according to the principle of three-step analgesia. The patients have better pain control and better quality of life.