Indian Journal of Palliative Care
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 ORIGINAL ARTICLE
Year : 2021  |  Volume : 27  |  Issue : 1  |  Page : 133--138

The use of methadone in pediatric cancer pain – A retrospective study from a Governmental Cancer Center in India


1 Palliative Access (PAX) Program; Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre; Two Worlds Cancer Collaboration-INCTR, Vancouver, British Columbia, Canada
2 Faculty of Medicine, Lund University, Lund, Sweden
3 Department of Pediatric Palliative Care; Department of Pain Relief and Palliative Care Society, MNJ Institute of Oncology and Regional Cancer Centre, Vancouver, British Columbia, Canada
4 Department of Pain Relief and Palliative Care Society, MNJ Institute of Oncology and Regional Cancer Centre, Vancouver, British Columbia, Canada
5 Department of Radiology, MNJ Institute of Oncology and Regional Cancer Centre, Vancouver, British Columbia, Canada
6 Department of Clinical Sciences, Oncology and Pathology, Faculty of Medicine, Lund University; Department of Oncology, Skane University Hospital, Region Skane, Lund, Sweden
7 Department of Clinical Sciences, Oncology and Pathology, Institute for Palliative Care, Faculty of Medicine, Lund University; Department of Palliative Care and Advanced Home Health Care, Primary Health Care Skane, Region Skane, Lund, Sweden

Correspondence Address:
Mikael Segerlantz
Palliative Care and Advanced Home Health Care, Sankt Lars Vag 90, 221 85 Lund
Sweden
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPC.IJPC_109_20

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Background: The management of cancer-related pain relies on access to opioids. When regular opioids are not tolerated, or are insufficient, methadone is an affordable and effective analgesic. Aim: The aim of the project was to describe the pattern of use and clinical experience of methadone in pediatric cancer pain at a governmental cancer hospital in Hyderabad, one of the four Indian cancer centers with permission to prescribe methadone. Methods: This was a retrospective study of medical records of all children, under the age of 18, who had been prescribed methadone from September 9, 2017, to November 19, 2019. Data on analgesic effect, prior and concomitant analgesic treatment, opioid side effects, and the handling of methadone were analyzed. Results: A total of 11 children were identified and studied. Methadone was introduced mainly when pain was uncontrolled by regular opioids. Initial daily doses ranged from 1 to 15 mg. The duration of treatment ranged from 7 to 307, with a median of 50 days in the nine patients where treatment exceeded one single dosage. Good analgesic effect was reported in 5/9 children, unchanged from previous analgesic treatment in three patients and without any effect in one child. No severe side effects were reported. Conclusion: Low-dose methadone in the treatment of pediatric cancer pain at a low-resource cancer center was safe and well tolerated by the patients, with long treatment durations. It was safely managed, administered with single to double daily dosages, hence easy for patients and family to handle, and an affordable treatment option.






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