p.154 抽出テキスト

射線治療とステロイドを併用すると鎮痛効果が強かった。有害作用はプラセボと比較して同程度であった。ほとんどの研究で試験期間が1 カ月未満であるため,ステロイドの長期投与による有害作用〔ステロイドミオパチー,口腔カンジダ症,高血糖,精神症状(うつ,不眠,せん妄),消化器症状,易感染性,骨粗鬆症〕は十分に評価されていない可能性がある(Vyvey 2010, Haywood 2015)。これまでの研究と委員会での議論より,1脊髄圧迫症候群を含む神経圧迫に伴う痛み,2放射線治療による一過性の痛みの悪化,3脳転移やがん性髄膜炎による頭蓋内圧亢進症状に伴う頭痛に対して,ステロイドを投与することとした(Chow 2015, Chang 2019)。以上より,がん疼痛のある患者に対して,鎮痛補助薬としてステロイドの投与を条件付きで推奨する。

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broplasty increases early pain relief rather than vertebroplasty alone in vertebral bone III章推奨