がんによる神経障害性疼痛の背景とその制御に影響する要因の分析

Abstract

We analyzed the background of neuropathic pain due to cancer and the factors that affect its control among 241 patients with cancer pain who were referred to our department from 2007 to 2012. The patients were divided into neuropathic pain (NP: 94 cases) and other pain groups (OP: 147 cases) for comparison of background factors and treatment interventions. There was no significant difference between the numerical rating scale (NRS) scores of the NP and OP groups both at the time of intervention at our department, and 3 weeks after the intervention at our department. In the study of treatment intervention, both groups had increased opioid and adjuvant analgesic usage, with analgesic usage increasing from the time of initial consultation at our department to the time of the intervention three weeks later. In particular, adjuvant analgesic usage had increased markedly from 24.5% to 91.5% in the NP group. The causative site of pain had been included in the irradiation area in all cases in which radiation therapy (RT) had been commenced within three weeks of the intervention. The RT enforcement rate was significantly higher in the NP vs. the OP group (36.1% vs. 19.7%; P=0.007). Our results suggest that neuropathic pain, which is generally intractable, can also be controlled by adjuvant analgesic usagec ombined with RT, as with other types of pain.