Bouhassira Didier, Luporsi Elisabeth, Krakowski Ivan
aINSERM U-987, CHU Ambroise Pare, APHP, Boulogne-Billancourt, France bCentre Alexis Vautrin, Vandoeuvre les Nancy, France cInstitut Bergonié, Bordeaux, France.
Pain. 2017 Jun;158(6):1118-1125. doi: 10.1097/j.pain.0000000000000895.
This prospective national multicenter study was carried out to estimate the prevalence and incidence of chronic pain with or without neuropathic characteristics in patients with cancer in France. All consecutive outpatients (n = 1885) seen over 2 weeks for cancer treatment in 12 oncology units were invited to participate in the study, and 1805 were included. Patients underwent a clinical examination during visit 1, and a questionnaire was completed to detect chronic pain (defined as daily pain for at least 3 months), and to characterize its intensity, location, and neuropathic characteristics (ie, DN4 score ≥4). The impact of pain on quality of life was assessed with the Brief Pain Inventory. Patients without pain at visit 1 were included in the incidence study and were seen at 3 and 6 months after visit 1. The overall prevalence of chronic pain was 28.2% (95% CI: 26.3-30.5), ranging from 22.5% to 35.4%, depending on the location of the primary tumor. Neuropathic characteristics were present in 20.9% of these patients, with a prevalence of 2.9% to 9.7%, depending on primary tumor location. Pain intensity and interference were higher in patients with neuropathic characteristics. In total, 1285 patients were included in the incidence study, 873 of whom were seen at least once, 3, or 6 months after the first visit. The incidence of chronic pain during the 6-month follow-up period ranged from 13% to 28%, depending on primary tumor location, and neuropathic characteristics were found in 19.9% of patients with chronic pain.
这项前瞻性全国多中心研究旨在估算法国癌症患者中伴有或不伴有神经病理性特征的慢性疼痛的患病率和发病率。邀请了12个肿瘤科室中连续两周前来接受癌症治疗的所有门诊患者(n = 1885)参与研究,最终纳入1805例患者。患者在第1次就诊时接受临床检查,并填写一份问卷,以检测慢性疼痛(定义为每日疼痛至少3个月),并描述其强度、位置和神经病理性特征(即DN4评分≥4)。使用简明疼痛量表评估疼痛对生活质量的影响。第1次就诊时无疼痛的患者被纳入发病率研究,并在第1次就诊后的3个月和6个月进行随访。慢性疼痛的总体患病率为28.2%(95%置信区间:26.3 - 30.5),根据原发肿瘤的位置,患病率在22.5%至35.4%之间。这些患者中有20.9%存在神经病理性特征,根据原发肿瘤位置,患病率在2.9%至9.7%之间。具有神经病理性特征的患者疼痛强度和干扰更高。共有1285例患者被纳入发病率研究,其中873例在首次就诊后至少3个月或6个月接受了随访。在6个月的随访期内,慢性疼痛的发病率在13%至28%之间,取决于原发肿瘤位置,在19.9%的慢性疼痛患者中发现了神经病理性特征。