Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
Department of Radiation Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA.
Adv Ther. 2021 Mar;38(3):1425-1446. doi: 10.1007/s12325-021-01640-x. Epub 2021 Feb 11.
While radiation therapy is increasingly utilized in the treatment paradigm of many solid cancers, the chronic effects of radiation therapies are poorly characterized. Notably, understanding radiation-specific chronic pain syndromes is paramount given that the diagnosis and management of these conditions can serve to prevent long-standing functional impairments, optimize quality of life, and even allow for continued radiotherapy candidacy. These radiation-specific chronic pain phenomena include dermatitis, mucositis, enteritis, connective tissue fibrosis, lymphedema, and neuropathic pain syndromes. It is necessary to maintain a low threshold of suspicion for appropriately diagnosing these conditions as there exists a variance in when these symptoms arise after radiation. However, we present key epidemiological data delineating vulnerable cancer populations for each pain syndrome along with the available evidence for the management for each specific condition.
虽然放射疗法在许多实体癌症的治疗模式中越来越多地被应用,但放射疗法的慢性影响还没有得到很好的描述。值得注意的是,了解特定于放射治疗的慢性疼痛综合征至关重要,因为这些病症的诊断和管理有助于预防长期的功能障碍,优化生活质量,甚至使患者能够继续接受放射治疗。这些特定于放射治疗的慢性疼痛现象包括皮炎、黏膜炎、肠炎、结缔组织纤维化、淋巴水肿和神经性疼痛综合征。有必要对这些病症保持较低的怀疑阈值,因为这些症状在放射治疗后出现的时间存在差异。然而,我们提供了关键的流行病学数据,划定了每种疼痛综合征的易患癌症人群,以及每种特定病症的管理的可用证据。