buprenorphine and Osteosarcoma

Little is known about the treatment of bone pain in animal models of bone cancer. In the present study, the orthotopic 143-B human osteosarcoma xenotransplantation model was used to address the following questions: (1) Can repetitive analgesic treatment extend the experimental period by prolonging the time to reach humane endpoints and (2) Does repetitive analgesic treatment affect bone tumour development and metastasis? The analgesics, buprenorphine and meloxicam, were either applied individually or in combination at 12 h intervals as soon as the animals began to avoid using the tumour cell injected leg. While control mice treated with NaCl showed continuous body weight loss, the major criterion previously for terminating the experiments, animals treated with analgesic substances did not. The control mice had to be sacrificed 26 days after tumour cell injection, whereas the groups of animals with the different pain treatments were euthanized after an additional eight days. Importantly, primary intratibial tumour growth was not affected in any of the experimental groups by any of the pain treatment procedures. Between days 26 and 34 after tumour cell injection an increase of about 100% of the number of lung metastases was found for the groups treated with buprenorphine alone or together with meloxicam, but not for the group treated with meloxicam alone. In summary, the results indicated that both buprenorphine and meloxicam are suitable analgesics for prolonging the experimental periods in an experimental intratibial osteosarcoma mouse model.

Topics: Analgesics, Opioid; Animal Welfare; Animals; Anti-Inflammatory Agents, Non-Steroidal; Bone Neoplasms; Buprenorphine; Disease Models, Animal; Drug Therapy, Combination; Female; Injections; Longevity; Lung Neoplasms; Meloxicam; Mice; Mice, SCID; Osteosarcoma; Pain Management; Thiazines; Thiazoles; Tibia

The case of a 78-year-old patient with cancer-related pain and additionally mixed-pain syndrome is presented. Pain therapy with buprenorphine TTS 210 microg/h every 3 days was sufficient in the beginning, later the therapy was changed because of increasing problems of tape fixing during fever periods under chemotherapy to a continuous infusion of buprenorphine intravenously via an external medication pump. During the course of therapy it became necessary to increase the dose to 99.9 mg/day buprenorphine. Under this medication a sufficient pain reduction (median NRS 2-3) over a period of 135 days could be achieved. At the same time the patient was vigilant and cooperative without signs of intoxication until the end of life at home in the presence of his family.If no signs of intoxication occur under extreme opioid therapy and a sufficient pain therapy can be achieved, a rotation to another opioid is not necessary. However, outpatient palliative care requires a frequent adaptation to the individually varying opioid demand of the patient and time-consuming nursing care.

Topics: Aged; Analgesics, Opioid; Buprenorphine; Combined Modality Therapy; Comorbidity; Disease Progression; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Femoral Neoplasms; Humans; Infusion Pumps, Implantable; Length of Stay; Male; Neoplasm Staging; Osteosarcoma; Pain Measurement; Pain, Intractable; Palliative Care; Treatment Outcome

Topics: Acute Disease; Adult; Analgesics, Opioid; Antineoplastic Agents, Alkylating; Buprenorphine; Humans; Ifosfamide; Male; Osteosarcoma; Pain; Pelvic Neoplasms; Respiratory Insufficiency; Skull Neoplasms