Coffeen Ulises, Sotomayor-Sobrino Marco Antonio, Jiménez-González Ariadna, Balcazar-Ochoa Luis Gerardo, Hernández-Delgado Pamela, Fresán Ana, Plancarte-Sanchez Ricardo, Arias-Muñóz Samantha Daniela, Ochoa-Aguilar Abraham
Laboratorio de Neurofisiología Integrativa. Investigaciones en Neurociencias y División de Investigación Clínica, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Clinical Research Division, Mexico City, Mexico.
Hospital Loma Linda, Translational Research Laboratory, Naucalpan, Mexico.
J Pain Res. 2019 May 3;12:1331-1339. doi: 10.2147/JPR.S186107. eCollection 2019.
Chemotherapy (CT) is one of the most commonly used pharmacological approaches in cancer treatment. However, CT induces damage to several tissues causing significant deleterious effects in cancer survivors being chemotherapy-induced neuropathic pain (CINP) among the most commonly reported. CINP is thought to be present in up to 68.1% of the patients within 1 month of receiving CT. Due to the fact that reliable statistic information is scarce in several Latin American countries' diagnosis and treatment of this side-effect may be delayed directly affecting patients. Therefore, the aim of the present study was to determine and present the incidence and features of CINP in patients with cancer attending the Pain Management Clinic at Mexicos' National Institute of Cancerology in Mexico City. We performed a retrospective, file-based analysis of all the patients treated in the Pain Management Clinic at the National Institute at Cancer in Mexico from January 2016 to January 2017. CINP was found in 30.9% of the patients. The basal VAS was on average 2.5 upon arrival to the Pain Management Unit and 2.4 at the end of treatment (>0.05). The patients with the highest risk of developing CINP were those treated with paclitaxel Odds ratio 8.3 (<0.01), followed by platins OR 4 (<0.01), vincristine OR 1.5 (=0.01) and thalidomide OR 1.1 (=0.01). Incidence of CINP was similar to previous reports; however, the number of variables related to this type of pain in our cohort may open a new line of research and highlight the importance of this particular issue to our health system. It is necessary to develop a mechanism to predict the risk of patients to suffer CINP and to search the mechanism to control and reduce the suffering related to the current treatments.
化疗(CT)是癌症治疗中最常用的药理学方法之一。然而,化疗会对多个组织造成损伤,给癌症幸存者带来显著的有害影响,其中化疗诱导的神经性疼痛(CINP)是最常报告的不良反应之一。据认为,在接受化疗的患者中,高达68.1%的患者在1个月内会出现CINP。由于几个拉丁美洲国家缺乏可靠的统计信息,这种副作用的诊断和治疗可能会延迟,直接影响患者。因此,本研究的目的是确定并呈现墨西哥城墨西哥国立癌症研究所疼痛管理诊所中癌症患者CINP的发病率和特征。我们对2016年1月至2017年1月在墨西哥国立癌症研究所疼痛管理诊所接受治疗的所有患者进行了基于病历的回顾性分析。在30.9%的患者中发现了CINP。患者到达疼痛管理科室时的基础视觉模拟评分(VAS)平均为2.5,治疗结束时为2.4(>0.05)。发生CINP风险最高的患者是接受紫杉醇治疗的患者,比值比为8.3(<0.01),其次是铂类药物,比值比为4(<0.01),长春新碱比值比为1.5(=0.01),沙利度胺比值比为1.1(=0.01)。CINP的发病率与先前的报告相似;然而,我们队列中与这种疼痛类型相关的变量数量可能开辟一条新的研究途径,并突出这个特殊问题对我们卫生系统的重要性。有必要建立一种机制来预测患者发生CINP的风险,并寻找控制和减轻与当前治疗相关痛苦的机制。