Ni Yuncheng, Deng Fang, Yu Shanzi, Zhang Jianping, Zhang Xiaoxue, Huang Dong, Zhou Haocheng
Department of Pain, the Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, People's Republic of China.
Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, People's Republic of China.
Breast Cancer (Dove Med Press). 2023 Jul 25;15:495-504. doi: 10.2147/BCTT.S413435. eCollection 2023.
Post-mastectomy pain syndrome is a common yet debilitating neuropathic complication after breast cancer procedures, resulting in significantly reduced quality of life. Recently, emerging evidence has supported the therapeutic effect of magnesium administration in chronic pain. However, the role of magnesium supplementation in development of chronic pain after breast cancer surgery remains less known. The aim of this study was to evaluate therapeutic effect of magnesium supplementation on persistent pain after breast cancer procedure.
This was a randomized, double-blind, placebo-controlled clinical trial. A total of 109 patients who underwent breast cancer procedure received magnesium-L-threonate (n = 48) or placebo (n = 61) for 12 weeks. Chronic pain incidence, short form of the McGill Pain Questionnaire (SF-MPQ), Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and Telephone Interview for Cognitive Status (TICS) were evaluated at 3- and 6-month follow-up.
About 31% (15 out of 48) of patients reported chronic pain after magnesium supplementation, and 26% (16 out of 61) of the control group at 6-month follow-up respectively. Total scores of SF-MPQ were significantly increased in the control group 6 months after surgical intervention (mean difference, 1.475; 95% CI, -2.730 to -0.2211), but NOT in the magnesium treated group (mean difference, 1.250; 95% CI, -2.775 to 0.2748). No significant differences were found between two cohorts on SF-MPQ, GAD-7, PHQ-9, PSQI, or TICS at each timepoint.
Oral supplementation of magnesium-L-threonate did not effectively prevent the development of persistent pain in breast cancer survivors, nor provide sufficient pain relief over placebo. We did not observe improvement of pain, mood, sleep disorder, or cognitive function after 12-week magnesium supplementation. Future study may focus on magnesium combined with other effective anti-neuropathic pain treatment.
乳房切除术后疼痛综合征是乳腺癌手术后常见且使人衰弱的神经性并发症,会导致生活质量显著下降。最近,新出现的证据支持了镁剂在慢性疼痛治疗中的作用。然而,补充镁在乳腺癌手术后慢性疼痛发生中的作用仍鲜为人知。本研究的目的是评估补充镁对乳腺癌手术后持续性疼痛的治疗效果。
这是一项随机、双盲、安慰剂对照的临床试验。共有109例接受乳腺癌手术的患者接受了12周的L-苏糖酸镁(n = 48)或安慰剂(n = 61)治疗。在3个月和6个月随访时评估慢性疼痛发生率、麦吉尔疼痛问卷简表(SF-MPQ)、广泛性焦虑障碍量表(GAD-7)、患者健康问卷-9(PHQ-9)、匹兹堡睡眠质量指数(PSQI)和认知状态电话访谈(TICS)。
在6个月随访时,补充镁后约31%(48例中的15例)的患者报告有慢性疼痛,对照组为26%(61例中的16例)。手术干预6个月后,对照组SF-MPQ总分显著增加(平均差值,1.475;95%CI,-2.730至-0.2211),但镁治疗组未增加(平均差值,1.250;95%CI,-2.775至0.2748)。在每个时间点,两个队列在SF-MPQ、GAD-7、PHQ-9、PSQI或TICS方面均未发现显著差异。
口服补充L-苏糖酸镁不能有效预防乳腺癌幸存者持续性疼痛的发生,也不能比安慰剂提供足够的疼痛缓解。在补充镁12周后,我们未观察到疼痛、情绪、睡眠障碍或认知功能的改善。未来的研究可能集中在镁与其他有效的抗神经性疼痛治疗方法的联合应用上。