老年癌痛管理:基于2025版NCCN成人癌痛指南的解读与思考

doi:10.3969/j.issn.1003-9198.2026.02.021

Abstract

Abstract: With the aging population, cancer pain has become a major factor affecting the quality of life of elderly patients with cancer. This article analyzes the latest updates of the 2025 National Comprehensive Cancer Network (NCCN) Adult Cancer Pain Guidelines. It uses the core cancer pain management process (assessment, intervention, and reassessment) as the framework to discuss management principles specifically tailored for elderly patients, so as to provide reference and guidance for clinical practice.

Key words: cancer pain, aged, NCCN, opioids

CLC Number:

R 730.6

LYU Jiajia, ZHONG Xiaoyou, GAO Yiteng, WANG Lin, FAN Weifei. Cancer pain management in the elderly: insights from the NCCN Guidelines Version 2.2025 Adult Cancer Pain[J]. Practical Geriatrics, 2026, 40(2): 211-216.

References

[1] SNIJDERS R A H, BROM L, THEUNISSEN M, et al. Update on prevalence of pain in patients with cancer 2022: a systematic literature review and meta-analysis[J]. Cancers, 2023, 15(3): 591.
[2] KWON J H. Overcoming barriers in cancer pain management[J]. J Clin Oncol, 2014, 32(16): 1727-1733.
[3] ROTTNEK F. Chasing the pendulum: the past, present, and future of opioids and older adults[J]. Innov Aging, 2025, 9(6): igaf040.
[4] AL-OBAIDI M, KOSMICKI S, HARMON C, et al. Pain among older adults with gastrointestinal malignancies- results from the cancer and aging resilience evaluation (CARE) Registry[J]. Support Care Cancer, 2022, 30(12): 9793-9801.
[5] BESSEDE A, MARABELLE A, GUÉGAN J P, et al. Impact of acetaminophen on the efficacy of immunotherapy in cancer patients[J]. Ann Oncol, 2022, 33(9): 909-915.
[6] MAGEE D J, JHANJI S, POULOGIANNIS G, et al. Nonsteroidal anti-inflammatory drugs and pain in cancer patients: a systematic review and reappraisal of the evidence[J]. Br J Anaesth, 2019, 123(2): e412-e423.
[7] DERRY S, BELL R F, STRAUBE S, et al. Pregabalin for neuropathic pain in adults[J]. Cochrane Database Syst Rev, 2019, 1(1): CD007076.
[8] FINNERUP N B, ATTAL N, HAROUTOUNIAN S, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis[J]. Lancet Neurol, 2015, 14(2): 162-173.
[9] CORLI O, FLORIANI I, ROBERTO A, et al. Are strong opioids equally effective and safe in the treatment of chronic cancer pain? A multicenter randomized phase IV ‘real life’ trial on the variability of response to opioids[J]. Ann Oncol, 2016, 27(6): 1107-1115.
[10] 中国抗癌协会肿瘤整体评估专业委员会. 阿片类药物不良反应综合防治专家共识(2024年版)[J]. 中国肿瘤临床, 2024, 51(15): 757-763.
[11] ABOU-KASSEM D, KURITA G P, SJØGREN P, et al. Long-term opioid treatment and endocrine measures in patients with cancer-related pain: a systematic review[J]. Scand J Pain, 2022, 22(3): 421-435.
[12] WANG D D, MA T T, ZHU H D, et al. Transdermal fentanyl for cancer pain: trial sequential analysis of 3406 patients from 35 randomized controlled trials[J]. J Cancer Res Ther, 2018, 14(Suppl 1): S14-S21.
[13] 杜美慧, 刘越, 曾永芬, 等. 美沙酮按需转换法治疗癌痛的临床研究[J]. 中国疼痛医学杂志, 2024, 30(3): 189-195.
[14] MERCADANTE S, LO CASCIO A, ADILE C, et al. Maddalena Opioid Switching Score in patients with cancer pain[J]. Pain, 2023, 164(1): 91-97.
[15] DAVIS M P, DAVIES A, MCPHERSON M L, et al. Opioid conversion in adults with cancer: MASCC-ASCO-AAHPM-HPNA-NICSO guideline[J]. Support Care Cancer, 2025, 33(3): 243.
[16] RUANO A, GARCÍA-TORRES F, GÁLVEZ-LARA M, et al. Psychological and non-pharmacologic treatments for pain in cancer patients: a systematic review and meta-analysis[J]. J Pain Symptom Manage, 2022, 63(5): e505-e520.
[17] 李淏, 李沛瑾, 刘婷婷, 等. 癌性疼痛中西医结合诊疗指南[J]. 中国全科医学, 2025, 28(30): 3729-3740.
[18] HE Y, GUO X, MAY B H, et al. Clinical evidence for association of acupuncture and acupressure with improved cancer pain: a systematic review and meta-analysis[J]. JAMA Oncol, 2020, 6(2): 271-278.
[19] FENG B, HU X, LU W W, et al. Are mindfulness treatments effective for pain in cancer patients? A systematic review and meta-analysis[J]. Eur J Pain, 2022, 26(1): 61-76.
[20] WARTH M, ZÖLLER J, KÖHLER F, et al. Psychosocial interventions for pain management in advanced cancer patients: a systematic review and meta-analysis[J]. Curr Oncol Rep, 2020, 22(1): 3.
[21] ALZOUBI Z, LOMAN B R. Nutrition interventions in the treatment of gastrointestinal symptoms during cancer therapy: a systematic review and meta-analysis[J]. Adv Nutr, 2025, 16(9): 100485.
[22] MERCADANTE S, CANDIDO K, STAATS P, et al. Spinal analgesia in cancer pain management-MASCC general practice recommendations[J]. Support Care Cancer, 2025, 33(8): 674.
[23] SCHUMACHER K L, PLANO CLARK V L, RABOW M W, et al. The experience of complex pain dynamics in oncology outpatients: a longitudinal qualitative analysis[J]. Cancer Nurs, 2021, 44(2): 136-144.

Cancer pain management in the elderly: insights from the NCCN Guidelines Version 2.2025 Adult Cancer Pain

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