Crispo Anna, Luongo Assunta, Nocerino Davide, Cascella Marco, Crisci Marco, Bifulco Francesca, Schiavo Daniela, Marchesini Maurizio, Coluccia Sergio, Prete Melania, Amore Alfonso, Celentano Egidio, Bimonte Sabrina, Cuomo Arturo
Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
Department of Anesthesia and Critical Care, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
Anticancer Res. 2025 Jul;45(7):3149-3164. doi: 10.21873/anticanres.17678.
BACKGROUND/AIM: Chronic secondary pain from cancer may flare into unexpected acute phases, called breakthrough cancer pain (BTcP). This phenomenon has a moderate-to-severe intensity and short latency between onset and peak of intensity, so clinical and therapeutic implications may be necessary. The Italian Oncologic Pain Multisetting-Multicentric Survey (IOPS-MS) aimed to characterize BTcP in a large number of patients from different settings and assess possible factors influencing its development. Previously, we observed differences according to sex in site, onset and level of BTcP. In this analysis, we assessed differences in non-predictable BTcP between female patients with female-specific cancer (FSC) (including breast and gynecological cancer) and those with non-FSC.
A univariate analysis compared patients with FSC (overall and separately for breast and gynecological cancer) and non-FSC. A multivariate analysis stratified by BTcP phenotype was performed to estimate the main determinants of the risk groups in patients with FSC (overall and separately for breast and gynecological cancer) and non-FSC. Odds ratios and 95% confidence intervals were reported.
The FSC group was younger, more often treated in clinics or day hospitals, and had an increased risk of locoregional/metastatic disease than the non-FSC group. Patients with breast cancer were at higher risk of locoregional/metastatic disease, less frequently treated by a palliative specialist and had later BTcP onset compared to the non-FSC group. Significant differences concerning age, care setting and BTcP onset were also found in the group of patients with FSC (overall and separately for breast and gynecological cancer) according to tumor extension.
Non-predictable BTcP in patients with FSC presents unique characteristics, particularly regarding pain onset, care settings, and metastasis. Differences between breast and gynecological cancer emphasize the need for tailored pain-management approaches.
背景/目的：癌症引起的慢性继发性疼痛可能会突然发作进入意想不到的急性期，即爆发性癌痛（BTcP）。这种现象强度为中度至重度，发作与强度峰值之间的潜伏期较短，因此可能需要临床和治疗方面的应对措施。意大利肿瘤疼痛多场景多中心调查（IOPS-MS）旨在描述来自不同场景的大量患者的BTcP特征，并评估影响其发生发展的可能因素。此前，我们观察到BTcP在部位、发作和程度方面存在性别差异。在本分析中，我们评估了患有女性特定癌症（FSC）（包括乳腺癌和妇科癌症）的女性患者与非FSC患者之间不可预测的BTcP差异。
进行单因素分析以比较FSC患者（总体以及分别针对乳腺癌和妇科癌症）与非FSC患者。进行按BTcP表型分层的多因素分析，以估计FSC患者（总体以及分别针对乳腺癌和妇科癌症）和非FSC患者风险组的主要决定因素。报告比值比和95%置信区间。
与非FSC组相比，FSC组患者更年轻，更常在诊所或日间医院接受治疗，局部/转移性疾病风险增加。与非FSC组相比，乳腺癌患者局部/转移性疾病风险更高，接受姑息治疗专家治疗的频率更低，BTcP发作更晚。根据肿瘤分期，FSC患者组（总体以及分别针对乳腺癌和妇科癌症）在年龄、护理环境和BTcP发作方面也存在显著差异。
FSC患者中不可预测的BTcP具有独特特征，特别是在疼痛发作、护理环境和转移方面。乳腺癌和妇科癌症之间的差异强调了需要采取针对性的疼痛管理方法。
