本研究调查了美国私人保险儿科癌症患者的大型全国样本中阿片类药物和非阿片类药物治疗的使用趋势和模式。我们确定了诊断患有中枢神经系统 (CNS) 的儿科（年龄 < 21）患者，来自 2005-2019 年 MarketScan 数据的淋巴瘤、性腺癌、白血病或骨癌。我们检查了在积极的癌症治疗期间服用以下 5 种药物治疗处方的患者比例：阿片类药物、抗惊厥药、非甾体抗炎药 (NSAID)、抗抑郁药和肌肉松弛药。我们使用多变量逻辑回归评估了药物治疗的趋势和模式。在 4174 名患者中，2979 名 (71%) 服用了阿片类药物； 746 人 (18%)、384 人 (9%)、202 人 (5%) 和 169 人 (4%) 分别服用过抗惊厥药、非甾体抗炎药、抗抑郁药和肌肉松弛剂处方。多变量逻辑回归显示，随着时间的推移，儿科癌症患者阿片类药物的使用呈非线性趋势，直到 2012 年，使用量略有增加（2012 年与 2006 年相比，OR 为 1.40 [95% CI，1.12-1.73]），但此后有所下降（ 2018 年与 2012 年的 OR 为 0.51 [0.37-0.68]。抗惊厥药、非甾体抗炎药和肌肉松弛剂的使用随时间显着线性增加（所有 P < .005）。近年来，儿科癌症患者中阿片类药物的使用呈下降趋势，而阿片类药物的使用呈上升趋势。用于疼痛管理的非阿片类药物疗法可能作为阿片类药物的替代品。© 作者 2023。由牛津大学出版社出版。

This study examined the trends and patterns of opioid and non-opioid pharmacotherapy use among a large national sample of privately insured pediatric patients with cancer in the United States.We identified pediatric (aged < 21) patients diagnosed with central nervous system (CNS), lymphoma, gonadal, leukemia, or bone cancer from MarketScan data 2005-2019. We examined the proportion of patients who filled a prescription for the following 5 types of pharmacotherapy: opioid, anticonvulsant, non-steroidal anti-inflammatory drug (NSAID), antidepressant, and muscle relaxant during active cancer treatment. We assessed the trends and patterns in pharmacotherapy using multivariable logistic regressions.Among 4174 patients included, 2979 (71%) had an opioid prescription; 746 (18%), 384 (9%), 202 (5%), and 169 (4%) had anticonvulsant, NSAID, antidepressant and muscle relaxant prescriptions, respectively. Multivariable logistic regression showed a nonlinear trend in the use of opioids among pediatric patients with cancer over time such that use slightly increased until 2012 (OR of 1.40 [95% CI, 1.12-1.73] for 2012 vs. 2006) but then decreased thereafter (OR of 0.51 [0.37-0.68] for 2018 vs. 2012). The use of anticonvulsants, NSAIDs, and muscle relaxants increased significantly linearly over time (all P < .005).There has been a downward trend in the use of opioids in recent years among pediatric patients with cancer and an upward trend in the use of non-opioid pharmacotherapy for pain management potentially as an alternative to opioids.© The Author(s) 2023. Published by Oxford University Press.