P2-169 - A retrospective investigation of low dose oxycodone injection in opioid naive elderly terminal cancer patients

Abstract

Background: Elderly cancer patients with poor performance status sometimes experience severe pain at the end of life. Patients presenting with severe pain that needs urgent relief should be treated with parenteral opioids. At our palliative care unit, low dose oxycodone injection (LD-OXJ) is often initiated by continuous subcutaneous infusion in elderly terminal cancer patients. The objective of this study is to investigate the efficacy and safety of LD-OXJ in opioid naive elderly terminal cancer patients retrospectively. Methods: From January 2014 to June 2015, we collected the data of opioid naive elderly (more than 75 years old) cancer patients those who were not chronically receiving opioids on a daily basis and started to be treated with LD-OXJ, defined as OXJ dose under 12.5 mg/day. We retrospectively investigated efficacy of pain relief and duration of LD-OXJ treatment, defined as the period for patients who were treated with LD-OXJ effectively. We also calculated duration of survival after LD-OXJ initiation. Results: The number of collected patients was 39 and median age was 84 years old. All patients had poor performance status (PS4). All patients were rapidly provided pain relief with initial dose of OXJ and continued to receive OXJ without switching to the other opioid. Mean initial dose of OXJ and maximum dose of OXJ were 7.1±2.3 mg/day and 15.2±9.9 mg/day, respectively. Median duration of LD-OXJ treatment and duration of survival after LD-OXJ initiation were 40.5 hours (95% CI 32.7-78.5) and 67.8 hours (95% CI 35.6-141.8), respectively. All patients experienced no severe adverse events related to OXJ such as respiratory depression. Conclusions: LD-OXJ in opioid naive elderly cancer patients was efficacious in pain relief for most of survival duration after LD-OXJ initiation without safety concern from this analysis. LD-OXJ is suggested to be one of possible options for opioid introduction in opioid naive elderly cancer patients at the end of life.