癌症患者转诊至放射治疗中心的非癌症疼痛的发生率和处理。

Incidence and management of noncancer pain in cancer patients referred to a radiotherapy center.

机构信息

*Radiation Oncology Unit, Department of Oncology ¶Palliative Therapy Unit, Department of Oncology **Surgery Unit, Department of Oncology §Department of Anesthesia, Intensive Care and Pain Medicine ∥Medical Direction; Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del S. Cuore, Campobasso #Hospice Madre Teresa di Calcutta, Larino ††Department of Radiation Oncology, Università Cattolica del S. Cuore, Roma, Italy †Department of Radiation Oncology, The Lacks Cancer Center Saint Mary's Health Care, Grand Rapids, MI ‡Department of Radiation Oncology, Black Lion Hospital, Addis-Ababa, Ethiopia.

出版信息

Clin J Pain. 2013 Nov;29(11):944-7. doi: 10.1097/AJP.0b013e31827eb5e6.

DOI:10.1097/AJP.0b013e31827eb5e6

PMID:23370088

Abstract

OBJECTIVES

The incidence of noncancer pain (NCP) in cancer patients is unknown. An analysis of incidence, severity, impact on quality of life (QoL), and appropriateness of NCP treatment in a cohort of cancer patients referred to a radiotherapy center is reported.

MATERIALS AND METHODS

Pain was scored from 0 (absence) to 3 (severe) and the adequacy of analgesic therapy was evaluated according to International Guidelines. Correlation between Pain Management Index and World Health Organization Analgesic Ladder was used to analyze the appropriateness of NCP treatment. In addition, pain was differentiated according to its origin and types and a comparison was performed between cancer pain (CP) and NCP.

RESULTS

A total of 903 patients were eligible and 865 (95.8%) were considered evaluable. Three hundred ninety-eight patients (46.0%) had pain. CP and NCP pain incidence was 11.2% and 34.8%, respectively. Pain intensity was higher in patients with CP versus NCP (P=0.021). A neuropathic pain lower incidence (P=0.024) in NCP versus CP was recorded. Moreover, NCP was more inadequately treated than CP (P<0.001). QoL was significantly lower in patients with NCP when compared with patients without pain (P<0.001). In addition, QoL of patients with CP was significantly lower than QoL of patients with NCP (P<0.001).

DISCUSSION

In a cancer patients' population referred to a radiotherapy center, the NCP incidence was higher than the CP incidence and NCP intensity was only slightly lower than CP. NCP was significantly pharmacologically undertreated and it was related to a decline in QoL.

摘要

目的

癌症患者中非癌症疼痛（NCP）的发生率尚不清楚。本文分析了放射治疗中心就诊的癌症患者队列中 NCP 的发生率、严重程度、对生活质量（QoL）的影响以及 NCP 治疗的适当性。

材料和方法

疼痛评分为 0（无）至 3（严重），并根据国际指南评估镇痛治疗的适当性。使用疼痛管理指数与世界卫生组织镇痛阶梯的相关性来分析 NCP 治疗的适当性。此外，根据疼痛的起源和类型对疼痛进行区分，并对癌症疼痛（CP）和 NCP 进行比较。

结果

共有 903 名患者符合条件，其中 865 名（95.8%）可评估。398 名患者（46.0%）有疼痛。CP 和 NCP 疼痛的发生率分别为 11.2%和 34.8%。CP 患者的疼痛强度高于 NCP 患者（P=0.021）。NCP 患者的神经病理性疼痛发生率低于 CP 患者（P=0.024）。此外，NCP 的治疗不足率高于 CP（P<0.001）。与无疼痛的患者相比，NCP 患者的 QoL 显著降低（P<0.001）。此外，CP 患者的 QoL 显著低于 NCP 患者（P<0.001）。