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PROPÓSITO: Se ha realizado un estudio observacional y retrospectivo para evaluar el modo de utilización y los efectos secundarios de fentanilo transdérmico (FTTS) en pacientes oncológicos en situación terminal. MATERIAL Y MÉTODOS: Se han evaluado estadísticamente pacientes incluidos en un programa de Atención Domiciliaria que recibieron tratamiento con FTTS. RESULTADOS: 112 pacientes (p) recibieron tratamiento con FTTS. Mediana de edad de 71.5 años (29-88). 102p presentaban dolor y 10 disnea. Tipo de dolor: visceral 55% p, óseo 25% p, neuropático 12.5%, muscular 5% p y otro 2.5% p. EVA inicial: media 5.9. La analgesia previa a la utilización de fentanilo fue: 31% p AINES, 32.2% p tramadol, 5.6% p codeína y 31% p morfina. La dosis mediana inicial de fentanilo fue 50mgr/hora (25-300). La dosis mediana final fue 75 mgr/hora (25-400). EVA final media: 3,3. La mediana de la duración del tratamiento fue de 44 días (1-372). 35 p (31%) presentaron náuseas G2-3, somnolencia 5 p, agitación y/o delirio 13 p. 81 p (72%) precisaron laxantes. En 10 p fue necesario rotar a otro opioide: 4 p por toxicidad y 6 p por mal control del dolor. CONCLUSIONES: El FTTS es un analgésico bien tolerado en pacientes terminales y proporciona una anal-gesia adecuada (91%), a un bajo coste en cuanto a yatrogenia intolerable (4%), tanto con paso previo con opioides como directamente desde primer escalón analgésico OMS. PURPOSE: An observational and retrospective study was performed in order to evaluate the activity and toxicity of transdermal fentanyl in patients with advanced cancer. MATERIAL AND METHODS: 112 patients treated by a home palliative care unit were studied. The characteristics of patients, analgesic treatments, and opioid rotation were analysed from the beginning of fentanyl administration to the death. RESULTS: The mean age of the patients (p) was 71.5 years (range, 29-88). The indication for opioid administration was pain in 102 and dyspnea in 10 patients. The type of pain was visceral in 56 p (55%), bony in 25 p (25%), neuropatic in 13 p (12.8%), muscular in 5 p (5%), and others in 3 p (2.1%). The baseline mean value of the pain analogical visual scale (AVS) was 5.9. The analgesics administered before fentanyl was given were tramadol (32.2%), NSAIDs (31%), morphine (31%) and codeine (5.6%). The median initial dose of fentanyl was 50 µg (range, 25-300). The final mean dose at the time of death was 75 µg (25-400). The final mean AVS was 3.3. The median treatment duration was 44 days (range, 1 to 372). It caused G2-3 nausea in 35 p (31%), somnolence in 13 p, and agitation in 5 p; 81 patients received laxatives. Opioid rotation with morphine was necessary in 10 p because of toxicity, and in 6 p because uncontrolled pain. CONCLUSIONS: Transdermal fentanyl is a well tolerated analgesic in patients with advanced cancer, providing a good analgesia in up to 91% of the patients previously treated with opioids, as well as of the patients proceeding directly from the first or second step of the WHO ladder.