Corriero Alberto, Giglio Mariateresa, Soloperto Rossana, Preziosa Angela, Stefanelli Cristina, Castaldo Mariapaola, Gloria Federica, Paladini Antonella, Guardamagna Vittorio A, Puntillo Filomena
Department of Interdisciplinary Medicine - ICU and Pain Therapy Unit, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124, Bari, Italy.
Department of Intensive Care, Brussels' University Hospital (HUB), Rue de Lennik 808, 1070, Brussels, Belgium.
Pain Ther. 2025 Jun 17. doi: 10.1007/s40122-025-00755-1.
Cancer-related pain (CrP) is one of the most frequent and debilitating issues that affect the quality of life of patients with cancer. Systemic analgesics, particularly opioids, have been the cornerstone of pain management. However, the following shortcomings of the mentioned therapies, such as side effects, tolerance, and inadequate relief in refractory cases, make implementing a more complete, multimodal treatment plan necessary. Interventional pain management (IPM) uses specific invasive procedures, with different degree of invasiveness, such as nerve blocks, neurolysis, neuromodulation, and intrathecal drug delivery systems to provide effective pain relief with reduced adverse effects compared with opioids. These approaches are frequently underutilized due to delayed referrals, insufficient awareness, and logistic inefficiencies, which delay access to pain management centers specializing in care for patients in pain. Recent technological advancements offer the potential to overcome these barriers, including artificial intelligence-driven decision support systems and automated referral pathways, enabling early intervention and individualized pain treatment plans. The future of CrP management should shift from the current reactive model to a proactive approach, enabling the earlier incorporation of interventional techniques into treatment plans. The integration of interdisciplinary collaboration and technological innovations will enhance cancer pain management and progress from current outdated approaches to provide more effective and timely pain relief for patients with chronic refractory cancer pain.
癌症相关疼痛（CrP）是影响癌症患者生活质量的最常见且使人衰弱的问题之一。全身镇痛药，尤其是阿片类药物，一直是疼痛管理的基石。然而，上述疗法存在以下缺点，如副作用、耐受性以及在难治性病例中缓解效果不佳，这使得实施更全面的多模式治疗方案成为必要。介入性疼痛管理（IPM）采用具有不同侵入程度的特定侵入性程序，如神经阻滞、神经溶解、神经调节和鞘内药物输送系统，与阿片类药物相比，能提供有效的疼痛缓解且副作用减少。由于转诊延迟、认识不足和后勤效率低下，这些方法经常未得到充分利用，这延误了患者获得专门为疼痛患者提供护理的疼痛管理中心的治疗。最近的技术进步提供了克服这些障碍的潜力，包括人工智能驱动的决策支持系统和自动转诊途径，从而实现早期干预和个性化疼痛治疗方案。CrP管理的未来应从当前的反应性模式转变为前瞻性方法，使介入技术能更早地纳入治疗方案。跨学科合作与技术创新的整合将加强癌症疼痛管理，并从当前过时的方法取得进展，为慢性难治性癌症疼痛患者提供更有效、更及时的疼痛缓解。
