Department of Pain Medicine, Palliative Care and Integrative Medicine, Children's Hospitals and Clinics of Minnesota, Minnesota 55404, USA.
Curr Opin Support Palliat Care. 2013 Jun;7(2):131-8. doi: 10.1097/SPC.0b013e3283615ebe.
Many children with cancer suffer from neuropathic pain. However, there are no published pediatric randomized controlled trials (RCTs), nor agreed upon pediatric treatment recommendations. Pediatric neuropathic pain in patients with malignancies is often underassessed and undertreated with ineffective therapies.
This article describes main themes in the literature and commonly used treatment strategies.
A combination of integrative, rehabilitative, and supportive therapies with pharmacotherapy, including first line medications such as NSAIDs, opioids, low-dose tricyclics, and gabapentinoids, appear to be successful treatment strategies. There is a dearth of evidence regarding the management of neuropathic pain in children with cancer; studies, especially RCTs, are desperately needed.
许多癌症患儿患有神经病理性疼痛。然而,目前尚无发表的儿科随机对照试验(RCT),也没有针对儿科的治疗建议。恶性肿瘤患儿的神经性疼痛常常评估不足,且治疗效果不佳。
本文描述了文献中的主要主题和常用的治疗策略。
综合康复和支持治疗与药物治疗相结合,包括非甾体抗炎药、阿片类药物、低剂量三环抗抑郁药和加巴喷丁类药物等一线药物,似乎是成功的治疗策略。关于癌症患儿神经病理性疼痛的管理,证据匮乏;非常需要开展研究,特别是 RCT。