Logan Henrietta L, Bartoshuk Linda M, Fillingim Roger B, Tomar Scott L, Mendenhall William M
Department of Community Dentistry and Behavioral Science, University of Florida, Room 5192, 1329 SW 16th Street, Gainesville, FL 32610-3628, USA Department of Radiation Oncology, University of Florida, Gainesville, FL 32610-3628, USA.
Pain. 2008 Nov 30;140(2):323-331. doi: 10.1016/j.pain.2008.09.004. Epub 2008 Oct 9.
Chronic pain following cancer-related treatment is emerging as a major concern. Heretofore, the pain level among 5-year survivors of head and neck cancer has received limited attention. This study proposes a predictive model for understanding factors associated with the elevated levels of chronic oral pain. Cancer survivors were drawn from a pool of 5-year survivors. A listed sample matched on sex, age, and zip code was purchased and served as a comparison group. Telephone interviews were conducted by a professional call center. Oral pain levels and the presence of metallic taste phantoms were significantly higher in the cancer survivor group than among the comparison group. The prevalence of chronic oral pain among the 5-year survivors was 43% compared to 13% for the comparison group. Hierarchical linear regression showed that among the 5-year survivors, the predictive model for spontaneous pain accounted for 24% of the variance, and for function-related pain the model accounted for 34% of the variance, with the presence of a phantom metallic taste making a significant independent contribution in both models. In the function-related pain model, depression and level of oral function quality of life (QOL) made significant independent contributions. The presence of oral pain is a significant problem among head and neck cancer survivors. The presence of metallic phantoms is an important new piece of evidence suggesting neural damage following cancer-directed treatment. Routine assessment of oral pain levels could improve current analgesic approaches among head and neck cancer survivors.
癌症相关治疗后的慢性疼痛正日益成为一个主要问题。在此之前，头颈癌5年幸存者的疼痛程度受到的关注有限。本研究提出了一个预测模型，以了解与慢性口腔疼痛水平升高相关的因素。癌症幸存者来自一组5年幸存者。购买了一个按性别、年龄和邮政编码匹配的列表样本作为对照组。由专业呼叫中心进行电话访谈。癌症幸存者组的口腔疼痛水平和金属味幻嗅的发生率显著高于对照组。5年幸存者中慢性口腔疼痛的患病率为43%，而对照组为13%。分层线性回归显示，在5年幸存者中，自发疼痛的预测模型解释了24%的方差变异，功能相关疼痛的模型解释了34%的方差变异，幻嗅金属味的存在在两个模型中都做出了显著的独立贡献。在功能相关疼痛模型中，抑郁和口腔功能生活质量（QOL）水平做出了显著的独立贡献。口腔疼痛的存在是头颈癌幸存者中的一个重大问题。金属味幻嗅的存在是一个重要的新证据，表明癌症定向治疗后存在神经损伤。对头颈癌幸存者的口腔疼痛水平进行常规评估可以改善目前的镇痛方法。
