Du Yanyuan, Li Yaoyuan, Hu Jieqing, Fang Ruiying, Liu Yuming, Cai Liu, Song Ying, Ma Susu, Gao Jin, Zhang Hanyue, Li Baihui, Xiong Hongtai, Yu Huibo, Yang Shenglei, Zhu Shuduo, Zheng Honggang
Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixiange, Xicheng District, Beijing, 100053, China.
Department of Rehabilitation Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
Pain Ther. 2025 Feb;14(1):47-66. doi: 10.1007/s40122-024-00679-2. Epub 2024 Nov 17.
Cancer is a major public health issue, with an estimated 20 million new cases and 9.7 million cancer-related deaths worldwide in 2022. Approximately 44.5% of patients experience cancer pain, significantly impacting their quality of life and causing physical and psychological burdens. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique, shows potential in managing cancer pain. This review summarizes current research on rTMS for cancer pain, focusing on pain directly caused by tumors, pain from cancer treatments, postoperative pain, and cancer-related symptoms. Additionally, rTMS shows promise in improving cancer-related fatigue, anxiety, depression, and cognitive dysfunction, which can indirectly reduce cancer pain. The analgesic mechanisms of rTMS include inhibiting nociceptive signal transmission in the spinal cord, modulating hemodynamic changes in brain regions, and promoting endogenous opioid release. High-frequency stimulation of the primary motor cortex (M1) has shown significant analgesic effects, improving patients' emotional and cognitive functions and overall quality of life. rTMS has a favorable safety profile, with most studies reporting no severe adverse events. In conclusion, rTMS holds substantial potential for cancer pain management, offering a non-invasive and multifaceted therapeutic approach. Continued research and clinical application are expected to establish rTMS as an essential component of comprehensive cancer pain treatment strategies, significantly enhancing the overall well-being of patients with cancer.
癌症是一个重大的公共卫生问题，2022年全球估计有2000万新发病例和970万癌症相关死亡病例。约44.5%的患者经历癌症疼痛，这对他们的生活质量产生重大影响，并造成身体和心理负担。重复经颅磁刺激（rTMS）是一种非侵入性神经调节技术，在管理癌症疼痛方面显示出潜力。本综述总结了目前关于rTMS治疗癌症疼痛的研究，重点关注肿瘤直接引起的疼痛、癌症治疗引起的疼痛、术后疼痛以及癌症相关症状。此外，rTMS在改善癌症相关的疲劳、焦虑、抑郁和认知功能障碍方面也显示出前景，这些可间接减轻癌症疼痛。rTMS的镇痛机制包括抑制脊髓中的伤害性信号传递、调节脑区的血流动力学变化以及促进内源性阿片类物质释放。对初级运动皮层（M1）进行高频刺激已显示出显著的镇痛效果，改善了患者的情绪和认知功能以及整体生活质量。rTMS具有良好的安全性，大多数研究报告无严重不良事件。总之，rTMS在癌症疼痛管理方面具有巨大潜力，提供了一种非侵入性的多方面治疗方法。持续的研究和临床应用有望使rTMS成为综合癌症疼痛治疗策略的重要组成部分，显著提高癌症患者的整体幸福感。
