Department of Oncology, Hospital Ramón y Cajal, Madrid.
Department of Oncology, Hospital Perpetuo Socorro, Alicante.
Ann Oncol. 2011 Apr;22(4):924-930. doi: 10.1093/annonc/mdq449. Epub 2010 Oct 6.
Thirty percent to ninety percent of cancer patients suffer from pain, including neuropathic pain (NP), which results in great burden for cancer patients. Thus, it was of great interest to determine NP prevalence in cancer patients in Spain, to raise awareness of the condition, and aiming to improve management of cancer NP.
A 1-month follow-up prospective epidemiological multicenter study was conducted to assess prevalence and management of NP in Spanish oncologic units. The first 10 cancer patients at each unit diagnosed with NP by the validated Douleur Neuropathique 4 questionnaire (DN4) were recruited.
Of 8615 screened patients, 2567 (30%) suffered from pain. From these, 33% had NP according to investigators and 19% according to DN4 test. Three hundred and sixty-six patients (mean age 62.6 years; 61.2% male) were recruited. Pain decrease at 1 month was greater in patients with metastases (P<0.01) and depended on treatment (P<0.05), with 'oxycodone' showing 50.4% pain relief.
NP prevalence in cancer pain is 33%. DN4 reports only about half the cancer NP cases diagnosed by clinicians. Pharmaceutical treatment of cancer pain, including NP, has a greater effect in patients with metastases and seems to depend on the specific treatment used.
30%至 90%的癌症患者患有疼痛，包括神经性疼痛（NP），这给癌症患者带来了巨大的负担。因此，确定西班牙癌症患者中 NP 的患病率，提高对该疾病的认识，并旨在改善癌症 NP 的管理，这非常重要。
进行了为期 1 个月的前瞻性流行病学多中心研究，以评估西班牙肿瘤单位中 NP 的患病率和管理情况。每个单位前 10 名被诊断为 NP 的癌症患者（通过验证的 Douleur Neuropathique 4 问卷[DN4]诊断）被招募。
在 8615 名筛查患者中，2567 名（30%）患有疼痛。其中，33%的患者根据研究者和 19%的患者根据 DN4 测试患有 NP。共招募了 366 名患者（平均年龄 62.6 岁；61.2%为男性）。转移患者的疼痛在 1 个月时减轻更多（P<0.01），且取决于治疗（P<0.05），其中“羟考酮”显示出 50.4%的疼痛缓解。
癌症疼痛中 NP 的患病率为 33%。DN4 报告的癌症 NP 病例仅为临床医生诊断的一半左右。包括 NP 在内的癌症疼痛的药物治疗在有转移的患者中效果更大，并且似乎取决于所使用的具体治疗方法。
