Radiotherapy-Specific Chronic Pain Syndromes in the Cancer Population: An Evidence-Based Narrative Review

Karri, Jay; Lachman, Laura; Hanania, Alexander N.; Marathe, Anuj; Singh, Mani; Zacharias, Nicholas; Orhurhu, Vwaire; Gulati, Amitabh; Abd‐Elsayed, Alaa

doi:10.1007/s12325-021-01640-x

Cited by 22 publications

(10 citation statements)

References 210 publications

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“…The symptomatology of RRNP is reliant on the anatomic areas of radiotherapy targeted. The three most commonly involved neural tissues include brachial plexopathy resulting from irradiation for lung or breast cancer, lumbosacral plexopathy after pelvic radiotherapy, and axial neuropathy of the spinal cord following cervical radiotherapy ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

“…At present, pain secondary to tumor have been universally appreciated, and the neurotoxicity of chemotherapy is increasingly recognized as well. In comparison, there exists a sparsity of direct data focused on radiotherapy-related neuropathic pain (RRNP) ( 6 ) despite the increased utilization of radiotherapy in cancer care and the overall increase in cancer survivorship.…”

Section: Introductionmentioning

confidence: 99%

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Enhanced acupuncture therapy for radiotherapy-related neuropathic pain in patients with gynecologic cancer: a report of two cases and brief review

Dan-feng,

Jian-cheng,

Shu-zhen

et al. 2023

Front. Neurol.

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As radiation therapy is increasingly utilized in the treatment of cancer, neuropathic pain (NP) is a common radiotherapy-related adverse effect and has a significant impact on clinical outcomes negatively. However, despite an improved understanding of neuropathic pain management, pain is often undertreated in patients with cancer. Herein, we reported two cases with radiotherapy-related neuropathic pain (RRNP) who presented a positive reaction to acupuncture. Patient 1 (a 73-year-old woman) with gynecologic cancer complained of burning and electric shock-like pain in the lower limb after radiotherapy. With the accepted combination of acupuncture and drugs, the pain was alleviated completely in 8 weeks. Patient 2 (a 64-year-old woman) accepted acupuncture in the absence of medication because of her inability to tolerate the adverse events of anticonvulsant drugs. She achieved remission of pain 4 weeks later. The results of this study showed that acupuncture might be promising for controlling the RRNP in patients with cancer, especially who were intolerant or unresponsive to medications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Enhanced acupuncture therapy for radiotherapy-related neuropathic pain in patients with gynecologic cancer: a report of two cases and brief review

Dan-feng,

Jian-cheng,

Shu-zhen

et al. 2023

Front. Neurol.

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“…Other tissue with slow turnover like nerves may present with late adverse effects. In the case of CC, patients primarily present pain due to enteritis, dermatitis and neuropathic pain which may include radiation-induced plexitis ( 11 , 12 ).. Chemotherapy plays a key role in CC, treatment, unfortunately these drugs may lead to microtubule disruption, mitochondrial damage, altered ion channel activity, neuroinflammation and myelin sheath destruction.…”

Section: Introductionmentioning

confidence: 99%

Pain management in cervical cancer

Aguiar-Rosas,

Plancarte-Sanchez,

Hernandez-Porras

et al. 2024

Front. Oncol.

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Cervical cancer (CC) occupies the second place in incidence and mortality among women in México. Despite this, Cervical Cancer continues to have a late diagnosis which leads to a high rate of complications. Pain represents the most feared and disabling symptom, being present in up to 86% of patients with advanced disease. The approach to managing pain in this population has not been studied and described to a full extent. In addition, there is a pressing need to provide concise recommendations to promote adequate pain control. We performed a review of the literature in CC and had experts in the field of pain management evaluate the evidence found. We then issued relevant recommendations on pharmacology and interventional pain management. Thus, the approach to pain management must be comprehensive and individualized, considering the timely and appropriate use of pharmacologic treatment as well as interventional procedures.

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“…Normal tissue damage induces toxicities such as oral mucositis, dermatitis, and neuropathy leading to aggravation of RT-induced acute pain. The severity of RT-induced toxicities and pain is dependent on the total dose, fractions and the duration of radiation delivered to normal tissue in addition to the variation in tissue tolerance to radiation 26, 27 .…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of Genetic Polymorphisms Associated with Acute Pain and Relevant Acute Toxicities Induced by Radiotherapy for Head and Neck Cancer

Salama

Geng

Rigert

et al. 2022

Preprint

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Background/objectivePain is the most common acute toxicity following radiation therapy (RT) for head and neck cancer (HNC). The multifactorial origin of radiotherapy-induced pain makes it highly challenging to manage in HNC patients. Multiple studies have been conducted to identify different germline genetic variants associated with cancer pain, however few of them focused on RT-induced acute pain. In this systematic review, we summarize potential mechanisms of acute pain after radiotherapy in HNC focusing on oral cavity/oropharyngeal cancer and identify genetic variants associated with radiotherapy-induced acute pain and other relevant acute toxicities.MethodsA comprehensive search of Ovid Medline, EMBASE and Web of Science databases using concepts and terms including “Variants”, “Polymorphisms”, “Radiotherapy”, “Acute pain”, “Acute toxicity” published up to February 28, 2022 was performed by two reviewers. Review articles and citations were reviewed manually. The reported SNPs associated with RT-induced acute pain and toxicities were reported, and the molecular function of the associated genes and pathways were described based on genetic annotation using The Human Gene Database; GeneCards.ResultsA total of 386 articles were identified electronically and an additional 8 articles were included after manual search. 39 articles were finally included. 51 variants were associated with 40 genes, of which 30 % had function in DNA damage response and repair, 25% in inflammatory and immune response, 17.5 % in cell death or cell cycle, and were associated with RT-inflammatory pain and acute mucositis or dermatitis. 4 variants in 4 genes were associated with neuropathy and neuropathic pain. 13 variants in 10 genes and were associated with RT-induced mixed types of post-RT-pain.ConclusionDifferent types of pain develop after RT, including inflammatory pain (acute mucositis and acute skin reaction); neuropathic pain; nociceptive pain; and mixed oral pain. Genetic variants involved in DNA damage response and repair, cell death, inflammation and neuropathic pathways may affect pain presentation post-RT. These variants could be used for acute pain prediction and personalized pain management in HNC patients receiving RT.

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Radiotherapy-Specific Chronic Pain Syndromes in the Cancer Population: An Evidence-Based Narrative Review

Cited by 22 publications

References 210 publications

Enhanced acupuncture therapy for radiotherapy-related neuropathic pain in patients with gynecologic cancer: a report of two cases and brief review

Enhanced acupuncture therapy for radiotherapy-related neuropathic pain in patients with gynecologic cancer: a report of two cases and brief review

Pain management in cervical cancer

Systematic Review of Genetic Polymorphisms Associated with Acute Pain and Relevant Acute Toxicities Induced by Radiotherapy for Head and Neck Cancer

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