Jing Doudou, Zhao Qian, Zhao Yibo, Lu Xiangdong, Feng Yi, Zhao Bin, Zhao Xiaofeng
Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China.
Department of Endocrine, The Second Hospital of Shanxi Medical University, Taiyuan, China.
Front Oncol. 2023 Mar 16;13:1156618. doi: 10.3389/fonc.2023.1156618. eCollection 2023.
Cancer-induced bone pain (CIBP) has a considerable impact on patients' quality of life as well as physical and mental health. At present, patients with CIBP are managed according to the three-step analgesic therapy algorithm proposed by the World Health Organization. Opioids are commonly used as the first-line treatment for moderate-to-severe cancer pain but are limited due to addiction, nausea, vomiting and other gastrointestinal side effects. Moreover, opioids have a limited analgesic effect in some patients. In order to optimize the management of CIBP, we must first identify the underlying mechanisms. In some patients, surgery, or surgery combined with radiotherapy or radiofrequency ablation is the first step in the management of CIBP. Various clinical studies have shown that anti-nerve growth factor (NGF) antibodies, bisphosphonates, or RANKL inhibitors can reduce the incidence and improve the management of cancer pain. Herein, we review the mechanisms of cancer pain and potential therapeutic strategies to provide insights for optimizing the management of CIBP.
癌症诱发的骨痛（CIBP）对患者的生活质量以及身心健康都有相当大的影响。目前，CIBP患者按照世界卫生组织提出的三阶梯镇痛疗法方案进行治疗。阿片类药物通常被用作中重度癌症疼痛的一线治疗药物，但由于成瘾、恶心、呕吐及其他胃肠道副作用而受到限制。此外，阿片类药物在一些患者中的镇痛效果有限。为了优化CIBP的治疗，我们必须首先明确其潜在机制。在一些患者中，手术，或手术联合放疗或射频消融是CIBP治疗的第一步。各种临床研究表明，抗神经生长因子（NGF）抗体、双膦酸盐或核因子κB受体活化因子配体（RANKL）抑制剂可降低癌症疼痛的发生率并改善其治疗效果。在此，我们综述癌症疼痛的机制及潜在治疗策略，以为优化CIBP的治疗提供见解。
