Sica Antonello, Casale Beniamino, Sagnelli Caterina, Di Dato Maria Teresa, Buonavolontà Pietro, Salzano Anna Maria, Sagnelli Evangelista, Famiglietti Vincenzo, Saracco Elisabetta, Tammaro Dario, Papa Alfonso
Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Department of Pain Therapy Monaldi Hospital-Azienda Ospedaliera di Rilievo Nazionale Ospedali dei Colli, Naples, Italy.
Front Neurol. 2020 Nov 13;11:550554. doi: 10.3389/fneur.2020.550554. eCollection 2020.
Even patients with lymphoproliferative diseases may develop a persistent chronic pain not responsive to usual treatments due to changes in antibody production and to some treatments like radiotherapy, chemotherapy, and the administration of monoclonal antibodies, which further impair the immune defense and induce chronic inflammatory phenomena acting as a substrate for a persistent chronic pain. Five patients with indolent lymphoproliferative diseases were treated for severe pain nonresponsive to other pain reliever treatments with SCS applied with an All-in-One Shot (OS) procedure. For all patients, the estimated survival time was of 5 years or more. All patients showed a significant reduction of the intensity of pain: the mean Numerical Rating Scale was 7.4 before treatment and 2.2 after. No patient developed adverse events. Supported by the data of this study, we believe that the habit to deprive patients with an indolent form of lymphoproliferative diseases of the possibility to reduce the intensity of chronic pain by SCS treatment is extremely reductive and frustrating.
即使是患有淋巴增殖性疾病的患者，也可能由于抗体产生的变化以及放疗、化疗和单克隆抗体给药等一些治疗方法而出现持续的慢性疼痛，这些治疗方法会进一步损害免疫防御并引发慢性炎症现象，从而成为持续性慢性疼痛的基础。五名患有惰性淋巴增殖性疾病的患者因对其他止痛治疗无反应的严重疼痛，接受了采用一体化注射（OS）程序应用的脊髓刺激疗法（SCS）治疗。所有患者的估计生存时间均为5年或更长。所有患者的疼痛强度均显著降低：治疗前平均数字评分量表评分为7.4，治疗后为2.2。没有患者出现不良事件。基于本研究的数据，我们认为，剥夺患有惰性形式淋巴增殖性疾病的患者通过脊髓刺激疗法治疗减轻慢性疼痛强度的可能性的做法极其不合理且令人沮丧。
