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乳腺癌治疗后患者疼痛的发生率:系统评价。

Prevalence of pain in patients with breast cancer post-treatment: A systematic review.

机构信息

Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

出版信息

Breast. 2018 Dec;42:113-127. doi: 10.1016/j.breast.2018.08.105. Epub 2018 Sep 4.

Abstract

PURPOSE

To evaluate the prevalence and severity of persistent pain after breast cancer treatment (PPBCT) in patients who received surgery, radiotherapy or a combination of treatments and to explore how different treatments and techniques impact pain.

METHODS

Medline, Embase and Cochrane Central databases were searched for articles which evaluated the prevalence of PPBCT. Search results were limited to studies addressing chronic post-surgical pain (CPSP), persistent post-surgical pain (PPSP), post-mastectomy pain syndrome (PMPS) or radiotherapy (RT) related pain in breast cancer patients and published in the English language. The primary outcome was the incidence or severity of PPBCT. Descriptive analyses were performed.

RESULTS

A total of 177 studies were included in this review. Overall, pain prevalence was 29.8% amongst 3746 patients (Group 1: 30 studies) post-surgery, 27.3% post-RT (Group 2: 41 studies, n = 15 019), and 21.8% amongst BC survivors who reported on the general prevalence of after receiving various combinations of BC treatment (Group 3: 106 studies, n = 135 437).

CONCLUSION

PPBCT remains to be a prevalent and complex clinical issue, despite a variety of different techniques and treatments. Various factors such as varying definitions of pain, inconsistent use of assessment tools and differences in methodology between studies may contribute to discrepancies in reports of PPBCT. A greater understanding of BC treatments and their impact on PPBCT may help identify potential risk factors, prevention and pain management strategies.

摘要

目的

评估接受手术、放疗或联合治疗的乳腺癌患者治疗后持续性疼痛(PPBCT)的发生率和严重程度,并探讨不同治疗方法和技术对疼痛的影响。

方法

检索 Medline、Embase 和 Cochrane Central 数据库,以评估 PPBCT 发生率的文章。检索结果仅限于评估慢性手术后疼痛(CPSP)、持续性手术后疼痛(PPSP)、乳腺癌患者乳房切除术后疼痛综合征(PMPS)或放疗(RT)相关疼痛的研究,并以英文发表。主要结局是 PPBCT 的发生率或严重程度。进行描述性分析。

结果

共纳入 177 项研究。总体而言,3746 例患者(第 1 组:30 项研究)手术后疼痛发生率为 29.8%,41 项研究(第 2 组:15019 例)放疗后疼痛发生率为 27.3%,106 项研究(第 3 组:135437 例)报告了各种乳腺癌治疗组合后总体发生率的 BC 幸存者疼痛发生率为 21.8%。

结论

尽管采用了多种不同的技术和治疗方法,PPBCT 仍然是一个普遍且复杂的临床问题。各种因素,如疼痛定义的差异、评估工具的使用不一致以及研究方法之间的差异,可能导致 PPBCT 报告的差异。进一步了解乳腺癌治疗及其对 PPBCT 的影响可能有助于确定潜在的风险因素、预防和疼痛管理策略。

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