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胰腺癌相关疼痛的管理

Pancreas Cancer-Associated Pain Management.

作者信息

Coveler Andrew L, Mizrahi Jonathan, Eastman Bory, Apisarnthanarax Smith Jim, Dalal Shalini, McNearney Terry, Pant Shubham

机构信息

Department of Medical Oncology, University of Washington, Seattle, Washington, USA.

Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

出版信息

Oncologist. 2021 Jun;26(6):e971-e982. doi: 10.1002/onco.13796. Epub 2021 May 12.

Abstract

Pain is highly prevalent in patients with pancreas cancer and contributes to the morbidity of the disease. Pain may be due to pancreatic enzyme insufficiency, obstruction, and/or a direct mass effect on nerves in the celiac plexus. Proper supportive care to decrease pain is an important aspect of the overall management of these patients. There are limited data specific to the management of pain caused by pancreatic cancer. Here we review the literature and offer recommendations regarding multiple modalities available to treat pain in these patients. The dissemination and adoption of these best supportive care practices can improve quantity and quality of life for patients with pancreatic cancer. IMPLICATIONS FOR PRACTICE: Pain management is important to improve the quality of life and survival of a patient with cancer. The pathophysiology of pain in pancreas cancer is complex and multifactorial. Despite tumor response to chemotherapy, a sizeable percentage of patients are at risk for ongoing cancer-related pain and its comorbid consequences. Accordingly, the management of pain in patients with pancreas cancer can be challenging and often requires a multifaceted approach.

摘要

疼痛在胰腺癌患者中极为普遍,且会加重该疾病的发病率。疼痛可能是由于胰腺酶分泌不足、梗阻和/或肿瘤对腹腔神经丛神经的直接压迫作用所致。采取适当的支持性护理以减轻疼痛是这些患者整体治疗的一个重要方面。关于胰腺癌所致疼痛的治疗,具体数据有限。在此,我们回顾相关文献,并针对可用于治疗这些患者疼痛的多种方式提出建议。传播并采用这些最佳支持性护理措施可改善胰腺癌患者的生活质量和数量。对实践的启示:疼痛管理对于提高癌症患者的生活质量和生存率至关重要。胰腺癌疼痛的病理生理学复杂且具有多因素性。尽管肿瘤对化疗有反应,但仍有相当比例的患者面临持续的癌症相关疼痛及其合并症后果的风险。因此,胰腺癌患者的疼痛管理具有挑战性,通常需要多方面的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd7d/8176967/7c3cafa71990/ONCO-26-e971-g001.jpg

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