普通癌痛及“围放疗期”癌痛患者规范化治疗进展

doi:10.3760/cma.j.issn.1004-4221.2020.01.017

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Abstract Cancer pain is one of the main symptoms of patients suffering from malignant tumors. If it is not timely treated,it will lead to refractory pain and increase the burden on both the individuals and society. In China,the program titled"Good Pain Management" has been carried out for nearly 7 years,which increases the overall assessment and treatment levels for cancer pain among medical personnel. Nevertheless, the clinical efficacy for cancer pain treatment is not satisfactory. As an important treatment for malignant tumors,radiation therapy is also one of the main methods for treating cancer pain. For the first time,we proposed the concept of "peri-radiotherapeutic period",and emphasized the continuous analgesic treatment for patients with cancer pain before,during and after radiotherapy. In this article,current status of cancer pain treatment at home and abroad was illustrated,and standardized assessment and management of cancer pain during the "peri-radiotherapeutic period" were summarized.

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	Articles by authors
	Tan Bingxu
	Cheng Yufeng

Key words： Cancer pain Neoplasm/radiotherapy Peri-radiotherapeutic period Opioid drug

Received: 08 July 2018

Corresponding Authors: Cheng Yufeng,Email:qlcyf@163.com

Cite this article:

Tan Bingxu,Cheng Yufeng. Progress on standardized treatment for patients with general cancer pain and cancer pain during "peri-radiotherapeutic period"[J]. Chinese Journal of Radiation Oncology, 2020, 29(1): 73-78.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2020.01.017 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2020/V29/I1/73

[1]Williams AC,CraigKD. Updating the definition of pain[J]. Pain,2016,157(11):2420-2423. DOI:10.1097/j.pain.0000000000000613.
[2]Johnson JR,LossignolD,Burnell-Nugent M,etal. An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics[J]. J Pain Sympt Manag,2013,46(2):207-218. DOI:10.1016/j.jpainsymman.2012.07.014.
[3]Caraceni A,Hanks G,Kaasa S,et al. Use of opioid analgesics in the treatment of cancer pain:evidence-based recommendations from the EAPC[J]. Lancet Oncol,2012,13(2):e58-68. DOI:10.1016/S1470-2045(12)70040-2.
[4]Fisch MJ,LeeJW,WeissM,etal. Prospective,observational study of pain and analgesic prescribing in medical oncology outpatients with breast,colorectal,Lung,or prostate cancer[J]. J Clin Oncol,2012,30(16):1980-1988. DOI:10.1200/JCO.2011.39.2381.
[5]Vuong S,Pulenzas N,DeAngelis C,et al. Inadequate pain management in cancer patients attending an outpatient palliative radiotherapy clinic[J]. Support Care Cancer,2016,24(2):887-892. DOI:10.1007/s00520-015-2858-7.
[6]Xia ZJ. Cancer pain management in China:current status and practice implications based on the ACHEON survey[J]. J Pain Res,2017(10):1943-1952. DOI:10.2147/JPR. S128533.
[7]ACHEON working group,Kim YC,Ahn JS,et al. Current practices in cancer pain management in Asia:a survey of patients and physicians across 10 countries[J]. Cancer Med,2015,4(8):1196-1204. DOI:10.1002/cam4.471.
[8]丁玥,杨萍,孙丽秋,等. 北京市30家医院住院癌症患者疼痛及控制状况的调查[J]. 中华护理杂志,2011,46(3):282-285. DOI:10.3761/j.issn.0254-1769.2011.03.023.
Ding Y,YangP,SunLQ,etal. Investigation of pain and control status of inpatient cancer patients in 30 hospitals in Beijing[J]. Chin J Nur,2011,46(3):282-285. DOI:10.3761/j.issn.0254-1769.2011.03.023.
[9]中国抗癌协会癌症康复与姑息治疗专业委员会(CRPC),中国抗癌协会临床肿瘤学协作专业委员会(CSCO).恶性肿瘤骨转移及骨相关疾病临床诊断临床诊疗指南(2014版)[M]. 北京:北京大学医学出版社,2014:9.
[10]殷蔚伯. 与临床放疗有关的放射生物学概念[A]//谷铣之,殷蔚伯,余子豪,等. 肿瘤放射治疗学[M].4版. 北京:中国协和医科大学出版社,2009:7-8.
[11]Takase H,Sakata T,Yamano T,et al. Advantage of early induction of opioid to control pain induced by irradiation in head and neck cancer patients[J]. Auris Nasus Larynx,2011,38(4):495-500. DOI:10.1016/j.anl.2010.12.012.
[12]RipamontiCI,SantiniD,MaranzanoE,etal. Management of cancer pain:ESMO clinical practice guidelines[J]. Ann Oncol,2012,23 Suppl 7:vⅡ139-154. DOI:10.1093/annonc/mds233.
[13]BhatnaqarS,GuptaM. Evidence-based clinical practice guidelines for interventional pain management in cancer pain[J]. Indian J PalliatCare,2015,21(2):137-147. DOI:10.4103/0973-1075.156466.
[14]Ahmed DG,MohamedMF,MohamedSA. Superior hypogastricplexus combined with ganglion imparneurolytic blocks for pelvicand/or perineal cancer pain relief[J]. Pain Physician,2015,18(1):E49-56.
[15]Van der Meulen IC,May AM,de Leeuw JR,et al. Long-term effect of a nurse-led psychosocial intervention on health-related quality of life in patients with head and neck cancer:arandomised controlled trial[J]. Br J Cancer,2014,110(3):593-601. DOI:10.1038/bjc.2013.733.
[16]Reyes-Gibby CC,Anderson KO,Morrow PK,et al. Depressive symptoms and health-related quality of life in breast cancer survivors[J]. J Womens Heal,2012,21(3):311-318. DOI:10.1089/jwh.2011.2852.
[17]Reddy A,Hui D,Bruera E. A successful palliative care intervention for cancer pain refractory to intrathecal analgesia[J]. J Pain Symp Manag,2012,44(1):124-130. DOI:10.1016/j.jpainsymman.2011.07.010.
[18]Zheng S,He L,Yang X,et al. Evaluation of intrathecal drug delivery system for intractable pain in advanced malignancies:A prospective cohort study[J]. Medicine,2017,96(11):e6354. DOI:10.1097/MD.0000000000006354.
[19]Heo BH,Pyeon TH,Lee HG,et al. Epiduralinfusion of morphine and levobupivacaine through a subcutaneous port for cancer pain management[J]. Korean J Pain,2014,27(2):139-144. DOI:10.3344/kjp.2014.27.2.139.
[20]Mao JJ,Xie SX,Farrar JT,et al. Arandomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use[J]. Eur J Cancer,2014,50(2):267-276. DOI:10.1016/j.ejca.2013.09.022.
[21]Yeh CH,Chien LC,Chiang YC,et al. Auricular point acupressure as an adjunct analgesic treatment for cancer patients:a feasibility study[J]. Pain Manag Nur,2015,16(3):285-293. DOI:10.1016/j.pmn.2014.08.005.
[22]Semrau R. The role of radiotherapy in the definitive and postoperative treatment of advanced head and neck cancer[J]. Oncol Res Treat,2017,40(6):347-352. DOI:10.1159/000477128.
[23]Barrett S,HannaGG,MarignolL. An overview on personalisation of radiotherapy prescriptions in locally advanced non-small cell lung cancer:Are we there yet?[J]. Radiother Oncol,2018,128(3):520-533. DOI:10.1016/j.radonc.2018.05.029.
[24]Tekatli H,Spoelstra FOB,Palacios M,et al. Stereotactic ablative radiotherapy (SABR) for early-stage central lung tumors:new insights and approaches[J]. Lung Cancer,2018,123(1):142-148. DOI:10.1016/j.lungcan.2018.07.002.
[25]Zhang M,Wu AJ. Radiation techniques for esophageal cancer[J]. Chin Clin Oncol,2017,6(5):45. DOI:10.21037/cco.2017.06.33.
[26]Dunne EM,FraserIM,LiuM. Stereotactic body radiation therapy for lung,spine and oligometastatic disease:current evidence and future directions[J]. Ann Transl Med,2018,6(14):283. DOI:10.21037/atm.2018.06.40.
[27]张亚茹,张如娟,王征,等. 放疗前患者癌痛状况调查[J]. 中国疼痛医学杂志,2017,23(3):232-235. DOI:10.3969/j.issn.1006-9852.2017.03.016.
Zhang YR,ZhangRJ,WangZ,etal. Survey of cancer pain in patients before radiotherapy[J]. Chin J Pain Med, 2017,23(3):232-235. DOI:10.3969/j.issn.1006-9852.2017.03.016.
[28]刘勇,宋正波,梁军,等. 羟考酮缓释片和吗啡即释片在中重度癌痛滴定中疗效及安全性比较的Meta分析[J]. 临床肿瘤学杂志,2016,21(7):585-592.
Liu Y,SongZB,LiangJ,etal. Meta-analysis of the efficacy and safety of oxycodone sustained-release tablets and morphine immediate-release tablets in the titration of moderate and severe cancer pain[J]. Chin Clin Oncol,2016,21(7):585-592.
[29]Bandieri E,Romero M,Ripamonti CI,et al. Randomized trial of low-dose morphine versus weak opioids in moderate cancer pain[J]. J Clin Oncol,2016,34(5):436-442. DOI:10.1200/JCO.2015.61.0733.
[30]Gammal RS,Hoffman JM. Leveraging precision medicine to mitigatemedication-safety challenges[J]. Am J Heal Syst Pharm,2017,74(24):2031-2032. DOI:10.2146/ajhp170679.
[31]Bell GC,Donovan KA,McLeod HL. Clinical implications of opioid pharmacogenomics in patients with cancer[J]. Cancer Cont,2015,22(4):426-432. DOI:10.1177/107327481502200408.
[32]Cuffari S."Weak" opioid analgesics. Codeine,dihydrocodeine and tramadol:no less risky than morphine[J]. Prescrire Int,2016,25(168):45-50.
[33]Beakley BD,Kaye AM,Kaye AD. Tramadol,pharmacology,side effects,and serotonin syndrome:a review[J]. Pain Physician,2015,18(4):395-400.
[34]Murino P,Mammucari M,Borrelli D,et al. Role of immediate-release morphine (MIR) in the treatment of predictable pain in radiotherapy[J]. J Pain Palliat Care Pharmacother,2011,25(2):121-124. DOI:10.3109/15360288.2011.554488.
[35]Nomiya T,Teruyama K,Wada H,et al. Time course of pain relief in patients treated with radiotherapy for cancer pain[J]. Clin J Pain.2010 Jan,26(1):38-42. DOI:10.1097/AJP.0b013e3181b0c82c.
[36]Culleton S,Kwok S,Chow E. Radiotherapy for pain[J]. Clin Oncol (R Coll Radiol),2011,23(6):399-406. DOI:10.1016/j.clon.2010.11.011.
[37]Hird A,Chow E,Zhang L,et al. Determining the incidence of pain flare following palliative radiotherapy for symptomatic bone metastases:results from three canadian cancer centers[J]. Int J Radiat Oncol Biol Phys,2009,75(1):193-197. DOI:10.1016/j.ijrobp.2008.10.044.
[38]Takase H,Sakata T,Yamano T,et al. Advantage of early induction of opioid to control pain induced by irradiation in head and neck cancer patients[J]. Auris Nasus Larynx,2011,38(4):495-500. DOI:10.1016/ j.anl.2010.12.012.
[39]McGuire DB,FultonJS,ParkJ,etal. Systematic review of basic oral care for the management of oral mucositis in cancer patients[J]. Support Care Cancer,2013,21(11):3165-3177. DOI:10.1007/s00520-013-1942-0.
[40]Raber-Durlacher JE,von Bültzingslöwen I,Logan RM,et al. Systematic review of cytokines and growth factors for the management of oral mucositis in cancer patients[J]. Support Care Cancer,2013,21(1):343-355. DOI:10.1007/s00520-012-1594-5.
[41]Saunders DP,Epstein JB,Elad S,et al. Systematic review of antimicrobials,mucosal coating agents,anesthetics,and analgesics for the management of oral mucositis in cancer patients[J]. Support Care Cancer,2013,21(11):3191-3207. DOI:10.1007/s00520-013-1871-y.
[42]TeyJ,LeongCN,CheongWK,etal. A phase Ⅱ trial of preoperative concurrent chemotherapy and dose escalated intensity modulated radiotherapy (IMRT) for locally advanced rectal cancer[J]. J Cancer,2017,8(16):3114-3121. DOI:10.7150/jca.21237.
[43]SujenthiranA,NossiterJ,CharmanSC,etal. National population-based study comparing treatment-related toxicity in men who received intensity modulated versus 3-dimensional conformal radical radiation therapy for prostate cancer[J]. Int J Radiat Oncol Biol Phys,2017,99(5):1253-1260. DOI:10.1016/j.ijrobp.2017.07.040.
[44]Hafiz A,AbbasiAN,AliN,etal. Frequency and severity of acute toxicity of pelvic radiotherapy for gynecological cancer[J]. J Coll Physicians Surg Pak,2015,25(11):802-806. DOI:11.2015/JCPSP.802806.
[45]BrzozowskaA,IdziakM,BurdanF,etal. Symptoms and treatment of radiation-induced reactions[J]. Pol Merkur Lekarski,2015,38(227):283-287.
[46]Frazzoni L,La Marca M,Guido A,et al. Pelvic radiation disease:updates on treatment options[J]. World J Clin Oncol,2015,6(6):272-280. DOI:10.5306/wjco.v6.i6.272.
[47]Grodsky MB,Sidani SM. Radiation proctopathy[J]. Clin Colon Rectal Surg,2015,28(2):103-111. DOI:10.1055/s-0035-1547337.
[48]ManasA,MonroyJL,RamosAA,etal. Prevalence of neuropathic pain in radiotherapy oncology units[J]. Int J Radiat Oncol Biol Phys,2011,81(2):511-520. DOI:10.1016/j.ijrobp.2010.05.047.
[49]GamiB,HarringtonK,BlakeP,etal. How patients manage gastrointestinal symptoms after pelvic radiotherapy[J]. Aliment Pharmacol Ther,2003,18(10):987-994. DOI:10.1046/j.1365-2036.2003.01760.x.
[50]VistadI,Cvancarova M,Kristensen GB,et al. A study of chronic pelvic pain after radiotherapy in survivors of locally advanced cervical cancer[J]. J Cancer Surviv,2011,5(2):208-216. DOI:10.1007/s11764-011-0172-z.
[51]Chang MC,ChangYC,ChiouJF,etal. Overcoming patient-related barriers to cancer pain management for home care patients. A pilot study[J]. Cancer Nur,2002,25(6):470-476. DOI:10.1097/00002820-200212000-00012.
[52]PachmanDR,BartonDL,SwetzKM,etal. Troublesome symptoms in cancer survivors:fatigue,insomnia,neuropathy,and pain[J]. J Clin Oncol,2012,30(30):3687-3696. DOI:10.1200/JCO.2012.41.7238.
[53]Brogan S,Junkins S. Interventional therapies for the management of cancer pain[J]. J Support Oncol,2010,8(2):52-59.
[54]ChevilleAL,BasfordJR. Role of rehabilitation medicine and physical agents in the treatment of cancer-associated pain[J]. J Clin Oncol,2014,32(16):1691-702. DOI:10.1200/JCO.2013.53.6680.
[55]Porter J,Jick H. Addiction rare in patients treated with narcotics[J]. N Engl J Med,1980,302(2):123.
[56]Friedman DP. Perspectives on the medical use of drugs of abuse[J]. J Pain Symp Manag,1990,5(1 Suppl):S2-5.
[57]Bhatnagar S,Gupta M. Integrated pain and palliative medicine model[J]. Ann Palliat Med,2016,5(3):196-208. DOI:10.21037/apm.2016.05.02. Epub 2016 May 24.
[58]Balboni TA,Fitchett G,Handzo GF,etal. State of the science of spirituality and palliative care research part Ⅱ:screening,assessment,and interventions[J]. J Pain Symp Manag,2017,54(3):441-453. DOI:10.1016/j.jpainsymman.2017.07.029.