Faculty of Medicine and Health Sciences, Department of Health Professions, Macquarie University, Sydney, Australia.
Pain. 2017 Nov;158(11):2082-2091. doi: 10.1097/j.pain.0000000000001004.
Pain is common, but often poorly managed after breast cancer treatment. Screening questionnaires and the Neuropathic Pain Special Interest Group (NeuPSIG) criteria are 2 clinical approaches used to determine whether pain has neuropathic components, which may enable better pain management. The aims of this review were (1) to synthesise data from the literature on neuropathic pain prevalence in women after breast cancer treatment; (2) to investigate whether the prevalence of neuropathic pain differed between studies using screening questionnaires and the NeuPSIG criteria. We searched for studies that administered a validated neuropathic pain screening questionnaire and/or the NeuPSIG criteria to women treated for early-stage (I-III) breast cancer. Thirteen studies using screening questionnaires (N = 3792) and 3 studies using components of the NeuPSIG criteria (N = 621) were included. Meta-analyses were conducted for questionnaire data but not for NeuPSIG criteria data because of inadequate homogeneity. Among all participants treated for early-stage breast cancer, pooled prevalence estimates (95% confidence interval) ranged between 14.2% (8.3-21.4) and 27.2% (24.7-88.4) for studies using screening questionnaires; studies using NeuPSIG criteria reported prevalence rates from 24.1% to 31.3%. Among those who reported pain after treatment, the pooled prevalence estimate (95% confidence interval) of neuropathic pain from screening questionnaires ranged from 32.6% (24.2-41.6) to 58.2% (24.7-88.4); studies using NeuPSIG criteria reported prevalence rates from 29.5% to 57.1%. These prevalence estimates are higher than those reported for other types of cancer, and emphasise the need to assess the contribution of neuropathic pain after breast cancer treatment.
PROSPERO registration CRD42015029987.
疼痛是常见的，但在乳腺癌治疗后往往管理不善。筛查问卷和神经病理性疼痛特殊兴趣小组（NeuPSIG）标准是用于确定疼痛是否具有神经病理性成分的两种临床方法，这可能有助于更好地管理疼痛。本综述的目的是：（1）综合文献中关于乳腺癌治疗后女性神经病理性疼痛患病率的数据；（2）研究使用筛查问卷和 NeuPSIG 标准的研究中神经病理性疼痛的患病率是否存在差异。我们检索了使用验证过的神经病理性疼痛筛查问卷和/或 NeuPSIG 标准对早期（I-III 期）乳腺癌进行治疗的女性的研究。纳入了 13 项使用筛查问卷（N=3792）和 3 项使用 NeuPSIG 标准组成部分的研究（N=621）。由于缺乏同质性，对问卷数据进行了荟萃分析，但对 NeuPSIG 标准数据未进行分析。在所有接受早期乳腺癌治疗的参与者中，使用筛查问卷的研究中，汇总的患病率估计值（95%置信区间）范围为 14.2%（8.3-21.4）至 27.2%（24.7-88.4）；使用 NeuPSIG 标准的研究报告的患病率为 24.1%至 31.3%。在那些报告治疗后疼痛的患者中，来自筛查问卷的神经病理性疼痛的汇总患病率估计值（95%置信区间）范围为 32.6%（24.2-41.6）至 58.2%（24.7-88.4）；使用 NeuPSIG 标准的研究报告的患病率为 29.5%至 57.1%。这些患病率估计值高于其他类型癌症的报告值，强调需要评估乳腺癌治疗后神经病理性疼痛的贡献。
PROSPERO 注册 CRD42015029987。
