Silverman Jonathan E, Gulati Amitabh
Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY 100652, USA.
Department of Anesthesiology, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY 10065, USA.
Pain Manag. 2018 Sep;8(5):389-403. doi: 10.2217/pmt-2018-0022.
Pain is a ubiquitous part of the cancer experience. Often the presenting symptom of malignancy, pain becomes more prevalent in advanced or metastatic disease and often persists despite curative treatment. Although management of cancer pain improved following publication of the WHO's analgesic ladder, when used in isolation, conservative approaches often fail to control pain and are limited by intolerable side effects. Interventional strategies provide an option for managing cancer pain that remains refractory to pharmacologic therapy. The purpose of this review is to investigate these strategies and discuss the risks and benefits which must be weighed when considering their use. Therapies anticipated to have an increasingly important role in the future of cancer pain management are also discussed.
疼痛是癌症患者普遍会经历的一部分。疼痛常常是恶性肿瘤的首发症状,在晚期或转移性疾病中更为普遍,并且尽管进行了根治性治疗仍常常持续存在。尽管自世界卫生组织的止痛阶梯疗法公布后,癌症疼痛的管理有所改善,但单独使用时,保守方法往往无法控制疼痛,且会受到难以忍受的副作用的限制。介入治疗策略为管理对药物治疗无效的癌症疼痛提供了一种选择。本综述的目的是研究这些策略,并讨论在考虑使用它们时必须权衡的风险和益处。还讨论了预计在未来癌症疼痛管理中发挥越来越重要作用的疗法。