Department of Pharmacy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.
Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, Ontario, M5S 3M2, Canada.
Support Care Cancer. 2020 Feb;28(2):589-598. doi: 10.1007/s00520-019-04845-7. Epub 2019 May 17.
Taxane acute pain syndrome (TAPS) is a clinically significant side-effect of taxane chemotherapy, often described as arthralgia and myalgia that occurs 2-3 days after infusion. The aim of this study was to assess pain descriptors used by patients during their experience of TAPS.
A clinical prospective cohort study was conducted on breast cancer patients who had not received prior chemotherapy and were asked to complete diaries on three consecutive docetaxel treatment cycles on days 1-7, 14, and 21 (acute phase). Questionnaires to assess pain severity, descriptors of pain, and the interference in activities due to pain were adapted from the Brief Pain Inventory and the McGill Pain Questionnaire. Telephone questionnaire follow-up was done at 1, 3, 6, 9, and 12 months following docetaxel (delayed phase).
The most commonly used descriptor for acute and chronic pain was "aching" (90-96%). However, in the delayed phase of the study, "burning" (32-50%), "radiating" (39-48%), and "sharp" (40-69%) were used more often. In both acute and chronic pain phases, most patients experienced moderate/severe pain regardless of the location. Pain in cycle 1 was predictive of pain in subsequent taxane cycles (p < 0.0001). Pain in cycle 3 was predictive of chronic pain (p < 0.002).
The descriptors used by patients experiencing chemotherapy-induced pain (ChIP) may be reflective of the underlying mechanisms. It is suspected that TAPS initiates as an acute inflammatory pain, which over time develops into neuropathic pain, known as chemotherapy-induced peripheral neuropathy (CIPN). However, the subjective pain experience varies from patient to patient.
紫杉烷急性疼痛综合征（TAPS）是紫杉烷化疗的一种显著的临床副作用，通常表现为输注后 2-3 天出现的关节痛和肌痛。本研究的目的是评估患者在经历 TAPS 时使用的疼痛描述符。
对未接受过化疗的乳腺癌患者进行临床前瞻性队列研究，要求他们在三个连续的多西紫杉醇治疗周期（第 1-7、14 和 21 天，即急性期）中填写日记。评估疼痛严重程度、疼痛描述符以及疼痛对活动干扰的问卷改编自简短疼痛量表和麦吉尔疼痛问卷。在多西紫杉醇治疗后 1、3、6、9 和 12 个月（延迟期）通过电话进行问卷调查。
急性和慢性疼痛最常用的描述符是“酸痛”（90-96%）。然而，在研究的延迟期，“烧灼感”（32-50%）、“放射状”（39-48%）和“锐痛”（40-69%）更常被使用。在急性和慢性疼痛阶段，大多数患者无论疼痛部位如何，都经历了中度/重度疼痛。第 1 周期的疼痛预测了后续紫杉烷周期的疼痛（p<0.0001）。第 3 周期的疼痛预测了慢性疼痛（p<0.002）。
经历化疗诱导性疼痛（ChIP）的患者使用的描述符可能反映了潜在的机制。据推测，TAPS 最初表现为急性炎症性疼痛，随着时间的推移发展为神经病理性疼痛，即化疗诱导性周围神经病（CIPN）。然而，患者的主观疼痛体验因人而异。
