[Feasibility to treat pediatric cancer pain with analgesics for adults and their efficacy].
Bibliographic record
Abstract
BACKGROUND & OBJECTIVE: Lacking enough knowledge of pediatric cancer pain and pediatric dosage form of analgesics, current treatment of pediatric cancer pain in China is unsatisfactory. This study was to probe the efficacy and safety of treating pediatric cancer pain with analgesics for adults through summarizing the experience of diagnosis and treatment in Cancer Center of Sun Yet-sen University. METHODS: Basing on the components and the endurable dosage of each component for children, we formulated the appropriate dosage and usage of a few analgesics (including sustained release tablets of morphine, oxycodone and transdermal fantanyl) available in China, most of which were used in adults. Cancer pain of 139 children with newly diagnosed tumors were treated according to the World Health Organization (WHO) analgesic ladder, including 19 cases of mild pain, 41 cases of moderate pain and 79 cases of severe pain. Efficacy and adverse events were evaluated. RESULTS: Of the 139 patients, 104 (74.8%) were treated with analgesics of 1 WHO ladder step, 35 (25.2%) were treated with increased WHO ladder steps (ladder 1-->2 or 2-->3) or reduced WHO ladder steps (ladder 3-->2 or 2-->1). The total response rate for pain relief was 100%: 129 (92.8%) patients had complete relief, 7 (5.0%) had obvious relief, 3(2.2%) had moderate relief. The median time for pain control was 5 days (range, 1-12 days). Sustained release tablets of morphine, transdermal fantanyl, and sustained release tablets of oxycodone were used in 20, 28, and 40 patients, respectively. The median ages of the 3 groups were 10 (5-18), 6 (2.3-16), and 5 (2.5-16) years, respectively. The median of maximum dosages of the 3 single drugs were 20 (10-70) mg, 25 (12.5-50) microg/h, and 10 (5-30) mg, respectively. The median doses used in the 3 groups were 100 (20-360) mg, 5 (1.25-7.5) mg, and 60 (10-200) mg, respectively. The non-steroid anti-inflammatory drug-induced adverse events were nausea and vomiting with very low frequencies. The weak opioid and strong opioid drug-induced adverse events included constipation, nausea, vomiting, and somnolence, all of which were reversible. No severe adverse events, including respiratory depression and drug addiction, happened. CONCLUSIONS: The WHO ladder approach for cancer pain is appropriate for children. Currently in China, most analgesics for adults could be used for pediatric cancer pain treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".