Prevalence of Neuropathic Pain in Radiotherapy Oncology Units

Journal Article · Sat Oct 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.05.047· OSTI ID:21587741

Manas, Ana ^[1]; Monroy, Jose Luis ^[2]; Ramos, Avelino Alia ^[3]; Cano, Carmen ^[4]; Lopez-Gomez, Vanessa ^[5]; Masramon, Xavier ^[6]; Perez, Maria ^[5]

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1. Servicio de Oncologia Radioterapica, Hospital Universitario La Paz, Madrid (Spain)
2. Servicio de Oncologia Radioterapica, Hospital Universitario de la Ribera, Valencia (Spain)
3. Servicio de Oncologia Radioterapica, Hospital Txagorritxu, Vitoria-Alava (Spain)
4. Servicio de Oncologia Radioterapica, Hospital de Torrecardenas, Almeria (Spain)
5. Medical Unit, Pfizer Espana, Alcobendas (Spain)
6. Department of Biometrics, European Biometrics Institute, Barcelona (Spain)

Purpose: Neuropathic pain (NP) in cancer patients severely impacts quality of life. Radiotherapy (RT) may cause NP, and at the same time, cancer patients visit RT units for pain relief. NP prevalence at these sites and current analgesic treatment should be assessed to improve management. Methods and Materials: This epidemiological, prospective, multicenter study was undertaken to assess NP prevalence, according to Douleur Neuropathique 4 questions questtionaire (DN4) test results, and analgesic management in cancer pain patients visiting RT oncologic units. Secondary analyses assessed NP etiology and pain intensity (using the Brief Pain Inventory-Short Form) and impact (using the Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study [MOS] for Sleep, and the Health Survey Short Form-12). Results: A total of 1,098 patients with any kind of pain were registered. NP prevalence was 31.1% (95% confidence interval, 28.4%--33.9%); 291 NP patients (mean age, 62.2 {+-}12.5 years and 57.7% men) were eligible for study; 49% of patients were overweight. The most frequent tumors were those of breast and lung, and stage IIIB was the most common cancer stage. The tumors caused 75% of NP cases. Anxiety, sleepiness, and depression were common. At 8 weeks, pain intensity and interference with daily activities decreased significantly for 50.8% of responders. Depression and anxiety (p < 0.0001) scores on the Physical Component Summary and Mental Component Summary measures (p < 0.0001) and all MOS-Sleep subscales, except for snoring, improved significantly. The percentage of satisfied patients increased from 13.8% to 87.4% (p < 0.0001) with the current analgesic treatment, which meant a 1.2- and 6-fold increase (p < 0.0001) in narcotic analgesics and anticonvulsants, respectively, compared to previous treatment. Conclusions: NP is highly prevalent at RT oncology units, with sleepiness, anxiety, and depression as frequent comorbidities. There is a need to improve management of NP with increased use of more specific NP-targeting drugs.

• OSTI ID: 21587741
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 81, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2010.05.047; PII: S0360-3016(10)00791-1; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANALGESICS
ANTICONVULSANTS
ETIOLOGY
LUNGS
MAMMARY GLANDS
NARCOTICS
NEOPLASMS
PAIN
RADIOTHERAPY
STANDARD OF LIVING
BODY
CENTRAL NERVOUS SYSTEM AGENTS
CENTRAL NERVOUS SYSTEM DEPRESSANTS
DISEASES
DRUGS
GLANDS
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
RESPIRATORY SYSTEM
SYMPTOMS
THERAPY