Chronic Pain and Neuropathy Following Adjuvant Chemotherapy

Ventzel, Lise; Madsen, Claus; Karlsson, Páll; Tankisi, Hatice; İşak, Barış; Fuglsang‐Frederiksen, Anders; Jensen, Anders Bonde; Jensen, Annette Østergaard; Jensen, Troels Staehelin; Finnerup, Nanna Brix

doi:10.1093/pm/pnx231

Cited by 40 publications

(49 citation statements)

References 43 publications

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“…Anderson et al did not observe altered cool or warm perception (Andersen et al, ). Of the 12 CIPN studies that evaluated thermal detection thresholds, four reported elevated WDT (Boyette‐Davis et al, , 2011a; Dougherty et al, ; Ventzel et al, ), two reported elevated CDT (Dougherty et al, ; Forsyth et al, ), and one reported that both CDT and WDT were elevated (Cata et al, ).…”

Section: Thermal Detection Thresholds (Cdt/wdt)mentioning

confidence: 99%

“…Our searches identified 189 potentially relevant studies, of which 41 full text reports were examined ( Figure 1). A total of 18 studies met the eligibility criteria ( Figure 1) (Andersen, Duriaud, Aasvang, & Kehlet, 2016;Andriamamonjy, Delmotte, Savinelli, Beaussier, & Coudore, 2017;Attal et al, 2009;Binder et al, 2007;Boyette-Davis et al, 2013, 2011aCaraceni et al, 2008;Cata et al, 2007;Dougherty, Cata, Burton, Vu, & Weng, 2007;Dougherty, Cata, Cordella, Burton, & Weng, 2004;Fallon et al, 2015;Forsyth et al, 1997;Hershman et al, 2011;Krøigård et al & Fallon, 2012;Velasco et al, 2015;Ventzel et al, 2017). Three studies included patients with tumour-related cancer pain (Andersen et al, 2016;Lipton et al, 1991;Scott et al, 2012).…”

Section: Included Studiesmentioning

confidence: 99%

“…Three studies included patients with tumour-related cancer pain (Andersen et al, 2016;Lipton et al, 1991;Scott et al, 2012). Fifteen studies included patients with chemotherapy induced peripheral neuropathy (CIPN) (Andriamamonjy et al, 2017;Attal et al, 2009;Binder et al, 2007;Boyette-Davis et al, 2013, 2011aCaraceni et al, 2008;Cata et al, 2007;Dougherty et al, 2007Dougherty et al, , 2004Fallon et al, 2015;Forsyth et al, 1997;Hershman et al, 2011;Krøigård et al, 2014;Velasco et al, 2015;Ventzel et al, 2017). Across all included studies 789 participants were included: 510 had cancer pain, 73 had non-painful cancer (QST data not extracted) and 206 were pain-free control participants.…”

Section: Included Studiesmentioning

confidence: 99%

“…Four studies evaluated MPS of which, one (25%) found alerted pain response to supra-threshold pinprick pain (Binder et al, 2007;Fallon et al, 2015;Scott et al, 2012;Ventzel et al, 2017…”

Section: Sensitivit Y (Mps)mentioning

confidence: 99%

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The use of quantitative sensory testing in cancer pain assessment: A systematic review

Martland

Rashidi

Bennett

et al. 2020

European Journal of Pain

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Objective To summarize the literature on the use of quantitative sensory testing (QST) in the assessment of pain in people with cancer and to describe which QST parameters consistently demonstrate abnormal sensory processing in patients with cancer pain. Databases and Data Treatment Medline, EMBASE, AMED, CINAHL, SCOPUS and CENTRAL were searched for observational or experimental studies using QST in patients with a cancer diagnosis and reporting pain. Search strategies were based on the terms “quantitative sensory testing”, “cancer”, “pain”, “cancer pain” and “assessment”. Databases were searched from inception to January 2019. Data were extracted and synthesized narratively, structured around the different QST modalities and sub‐grouped by cancer pain aetiology (tumour‐ or treatment‐related pain). Results Searches identified 286 records of which 18 met the eligibility criteria for inclusion. Three studies included patients with tumour‐related pain, and 15 studies included patients with pain from chemotherapy‐induced peripheral neuropathy (CIPN). Across all studies, 50% (9/18) reported sensory abnormities using thermal detection thresholds (cool and warm), 44% (8/18) reported abnormal mechanical detection thresholds using von‐Frey filaments and 39% (7/18) found abnormal pinprick thresholds. Abnormal vibration and thermal pain (heat/cold) thresholds were each reported in a third of included studies. Conclusion This systematic review highlights the lack of published data characterizing the sensory phenotype of tumour‐related cancer pain. This has implications for our understanding of the underlying pathophysiological mechanisms of cancer pain. Understanding the multiple mechanisms driving cancer pain will help to move towards rational individualized analgesic treatment choices. Significance This systematic review found that pain in cancer patients is associated with abnormal sensory responses to thermal, mechanical and pinprick stimuli. However, these findings are based primarily on studies of chemotherapy‐induced peripheral neuropathy and data on tumour‐related pain are lacking, warranting further research.

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Section: Thermal Detection Thresholds (Cdt/wdt)mentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

“…Four studies evaluated MPS of which, one (25%) found alerted pain response to supra-threshold pinprick pain (Binder et al, 2007;Fallon et al, 2015;Scott et al, 2012;Ventzel et al, 2017…”

Section: Sensitivit Y (Mps)mentioning

confidence: 99%

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The use of quantitative sensory testing in cancer pain assessment: A systematic review

Martland

Rashidi

Bennett

et al. 2020

European Journal of Pain

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“…Because of the long time span between treatment and assessment of overall neuropathy by SCIN, there is a risk that the symptoms reported by the patients are not related to the treatment. In addition, SCIN does not separate bilateral from unilateral symptoms, although chemotherapy‐related peripheral neuropathy is usually bilateral . There are also some limitations concerning the SCIN when assessing Raynaud's phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Long‐term neurotoxicity and Raynaud's phenomenon in patients treated with cisplatin‐based chemotherapy for malignant ovarian germ cell tumor

Solheim

Skalleberg

Warncke

et al. 2018

Acta Obstet Gynecol Scand

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Introduction The aim was to evaluate “overall neuropathy”, defined as peripheral paresthesia and Raynaud's phenomenon, in long‐term survivors of malignant ovarian germ cell tumors (MOGCTs) treated with cisplatin‐based chemotherapy (CBCT). Material and methods Ninety‐three MOGCT survivors recorded in Norway in 1980‐2009 (median follow up: 15 years) were included in this analysis. Forty‐nine received CBCT (CBCT group) and 44 received other or no chemotherapy (non‐CBCT group). Applying the scale for chemotherapy‐induced neurotoxicity, the prevalence of overall neuropathy (ie score >1 on a 0‐3 scale) was compared between the two groups. Forty women from the CBCT group also underwent neurophysiological and neurological examinations; results from the neurological examination were graded according to the National Cancer Institute‐Common Terminology Criteria for Adverse Effects version 4 (NCI‐CTCAE scale v4). These women were then categorized into subgroups of low (≤3 cycles of CBCT, n = 23) and high CBCT (≥4 cycles of CBCT, n = 17). Results Twenty‐eight (57%) women from the CBCT group reported overall neuropathy, compared with 20 (45%) in the non‐CBCT group (P = .06). Of the 40 MOGCT survivors in the CBCT group who underwent neurophysiological and neurological examinations, 14 (35%) showed NCI‐CTCAE grade ≥1 signs or symptoms of peripheral neuropathy. Pathological findings of NCI‐CTCAE grade 2 or 3 signs or symptoms were found in four survivors (10%) from the high CBCT subgroup, all of whom also showed objective signs of neuropathy. Conclusions Though about half of our MOGCT survivors reported overall neuropathy after CBCT, more severe pathological neurological/neurophysiological findings that impacted daily living were recorded in only 10% of them. Our observations of a similar prevalence of self‐reported overall neuropathy in the CBCT and non‐CBCT group, combined with limited objective neurological findings, warrant further study to increase the understanding of the specific pathophysiological pathways of long‐term CBCT‐induced neuropathy.

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Adaptation to tonic heat in healthy subjects and patients with sensory polyneuropathy

Campolo

Correa

Gabarrón

et al. 2022

European Journal of Pain

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Background: Adaptation to a constant sensory stimulus involves many sites along the path of sensory volleys towards perception. The evaluation of such phenomenon may be of clinical interest. We studied adaptation to a constant temperature stimulus in healthy subjects to set normative data and in patients with sensory polyneuropathy (SPN), as proof of concept.Methods: Twenty-six healthy subjects and 26 patients with SPN in the context of chemotherapy treatment with oxaliplatin for colon cancer were instructed to express through an electronic VAS system (eVAS); the level of sensation felt when a thermode set at either 39º, 41º, 43º, 45º or 47º was applied to their ventral forearm. Results:The eVAS recordings showed typically an abrupt onset that slowed to approach maximum sensation and continued with a slow decrease indicating adaptation. The time to respond (TR), the velocity of the initial response (VR), the maximum sensation (MA), the time to reach MA (MAt), the onset of adaptation (AO) and the decrease in the sensation level with respect to MA at 30 s after stimulus application (SL30), were dependent on the temperature level in all subjects. However, patients showed significantly delayed TR, slowed VR, decreased MA, delayed AO and reduced SL30, with respect to healthy subjects. Differences were more pronounced at low-temperature levels, with absent AO in 25 patients versus 2 healthy subjects at temperatures of 39º and 41ºC. Conclusion:The study of adaptation to a constant temperature stimulus can furnish valuable data for the assessment of patients with SPN. Significance:We studied perceptual changes in the intensity of thermoalgesic sensation during 30 s of constant temperature stimulation after an abrupt initial contact in healthy subjects and patients with sensory polyneuropathy. Patients showed delayed time to respond, decreased maximal sensation and reduced adaptation with respect to healthy subjects. Differences were more pronounced at low and intermediate temperatures (39ºC to 43ºC). The method is of easy implementation and shows clinically relevant abnormalities in patients with sensory polyneuropathy.

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Chronic Pain and Neuropathy Following Adjuvant Chemotherapy

Cited by 40 publications

References 43 publications

The use of quantitative sensory testing in cancer pain assessment: A systematic review

The use of quantitative sensory testing in cancer pain assessment: A systematic review

Long‐term neurotoxicity and Raynaud's phenomenon in patients treated with cisplatin‐based chemotherapy for malignant ovarian germ cell tumor

Adaptation to tonic heat in healthy subjects and patients with sensory polyneuropathy

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