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接受抗癌治疗的癌症患者及抗癌治疗结束后的癌症幸存者疼痛患病率评估:一项法国全国性横断面研究。

Assessment of pain prevalence in cancer patients undergoing anticancer treatments and in cancer survivors after completion of anticancer treatments: A French nationwide cross-sectional study.

作者信息

Ragusa Charles, Pereira Bruno, Balayssac David

机构信息

Université Clermont Auvergne, INSERM U1107, NEURO-DOL, CHU Clermont-Ferrand, Direction de la Recherche Clinique et de l'Innovation, Clermont-Ferrand, France.

CHU Clermont-Ferrand, Direction de la Recherche Clinique et de l'Innovation, Clermont-Ferrand, France.

出版信息

Int J Cancer. 2025 May 15;156(10):1873-1884. doi: 10.1002/ijc.35280. Epub 2024 Dec 3.

DOI:10.1002/ijc.35280
PMID:39625069
Abstract

Pain is a common and disabling symptom of cancer and its treatment. This study aimed to provide an update on the prevalence, characteristics, and impact of pain on quality of life (QoL) in cancer patients and survivors in France. Data were collected using self-assessment questionnaires as part of a nationwide web-based survey conducted between January and March 2023. Pain was reported by 44.7% of the study population (n = 1029), including by 49.2% (95% CI [44.8; 53.6]) of cancer patients (n = 255/518) and 40.1% (95% CI [35.8; 44.5]) of cancer survivors (n = 205/511). Chronic pain was more prevalent among survivors (99.0%) than patients (87%), but no between-group differences in the prevalence of neuropathic pain (66.8% vs. 67.5%, respectively) or other pain characteristics (pain intensity, location, etc.) were observed. Pain had a negative impact on QoL in both groups, but the impact on global health status, functioning, symptom severity, and depression was greater among cancer patients. Analgesic use was also more frequent among patients than survivors. Breast cancer, being overweight or obese, and having a poorer global health status were identified as main factors increasing the likelihood of pain. Pain therefore remains a common symptom among cancer patients and survivors in France. Further improvements to management are needed, including strategies to target chronic and neuropathic pain, and the high frequency of pain associated with breast cancer. Multimodal interventions to improve global health status, help individuals maintain a healthy weight, and reduce the impact of cancer pain on QoL could also be evaluated.

摘要

疼痛是癌症及其治疗过程中常见且使人功能受限的症状。本研究旨在更新法国癌症患者及幸存者中疼痛的患病率、特征及其对生活质量(QoL)的影响。作为2023年1月至3月开展的一项全国性网络调查的一部分,通过自我评估问卷收集数据。44.7%的研究人群(n = 1029)报告有疼痛,其中49.2%(95%置信区间[44.8; 53.6])的癌症患者(n = 255/518)和40.1%(95%置信区间[35.8; 44.5])的癌症幸存者(n = 205/511)报告有疼痛。慢性疼痛在幸存者中(99.0%)比患者中(87%)更为普遍,但在神经病理性疼痛的患病率(分别为66.8%和67.5%)或其他疼痛特征(疼痛强度、部位等)方面未观察到组间差异。疼痛对两组的生活质量均有负面影响,但对癌症患者在总体健康状况、功能、症状严重程度和抑郁方面的影响更大。患者中使用镇痛药的频率也高于幸存者。乳腺癌、超重或肥胖以及总体健康状况较差被确定为增加疼痛可能性的主要因素。因此,在法国,疼痛仍是癌症患者和幸存者中的常见症状。需要进一步改进管理措施,包括针对慢性和神经病理性疼痛以及与乳腺癌相关的高发性疼痛的策略。还可以评估改善总体健康状况、帮助个体保持健康体重以及减轻癌症疼痛对生活质量影响的多模式干预措施。

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