Curing trial of complicated oncologic pain by D-phenylalanine


Donzelle G, Bernard L, Deumier R




Anesth Analg


Aim of investigations: Very often, chronic pain treatments used for the management of terminal ill cancer patients do not prevent acute or incident pain from coming up. For twenty months D-phenylalanine (DPA), an enkephalinase inhibitor, has been investigated in order to forestall this pain. Methods: Nine caucasian patients, three males and six females, between forty-nine and seventy-eight, were selected for this trial after informed consent. They were all undergoing severe incident pains related to complications (scabies, osteoporosis, painful cough or colic, Charley-Horse, RX-necrosis of skin or mucous membranes, etc) in spite of having their chronic pain component cured: phanol-rhizotomy: two cases, neuro-adrenolysis by alcohol: four cases, Brampton mixture: three cases. They were administered DPA, 250 mg three times a day for fifteen days, followed by a ten days pause, resumption and so on. Results: Seven patients out of nine were alleviated and they never claimed for more or other analgesics until they died. Four of them got very good ataraxia during the same time (survival mean x = 99,33 days). No side effect was reported, even in patients taking Brampton mixture. Conclusions: DPA seems a useful drug to prevent acute or incident pain in malignant diseases. Our data point out the consequences the enkephalinases inhibitors will take up for the cure of intractable cancer pain.