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Support Care Cancer. 2017 Dec;25(12):3759-3767. doi: 10.1007/s00520-017-3806-5. Epub 2017 Jul 8.

Multicenter, cross-sectional observational study of the impact of neuropathic pain on quality of life in cancer patients.

Author information

1
Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.
2
Medical Oncology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, 136-705, Republic of Korea. shinsw@kumc.or.kr.
3
Internal Medicine, Ulsan University College of Medicine, Ulsan, South Korea.
4
Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, South Korea.
5
Internal Medicine, Seoul National University Bundang Hospital, Soengnam-Si, South Korea.
6
Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea.
7
Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea.
8
Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
9
Internal Medicine, Dongsan Medical Center, Keimyung University, Daegu, South Korea.
10
Internal Medicine, Bobath Memorial Hospital, KyungGi, Soengnam-Si, South Korea.
11
Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea.
12
Internal Medicine, Chonbuk National University College of Medicine, Chonbuk, South Korea.
13
Internal Medicine, Daegu Fatima Hospital, Daegu, South Korea.
14
Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.
15
Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
16
Internal Medicine, Sungkyunkwan University College of Medicine Kangbuk Samsung Hospital, Seoul, South Korea.
17
Internal Medicine, Kyung Hee University Medical Center, Seoul, South Korea.
18
Internal Medicine, Hallym University Chuncheon Medical Center, Chuncheon, South Korea.
19
Internal Medicine, Pusan National University Hospital, Pusan, South Korea.
20
Internal Medicine, Korea University Guro Hospital, Seoul, South Korea.
21
Internal Medicine, Chungbuk National University College of Medicine, Chungbuk, South Korea.
22
Internal Medicine, Chungnam National University College of Medicine, Chungnam, South Korea.
23
Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea.
24
Internal Medicine, Konkuk University Medical Center, Seoul, South Korea.
25
Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea.
26
Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
27
Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea.
28
Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, South Korea.
29
Corporate Affairs & Health and Value, Pfizer Pharmaceutical Korea Ltd., Seoul, South Korea.

Abstract

PURPOSE:

Neuropathic cancer pain (NCP) is a common and potentially debilitating symptom in cancer patients. We investigated the prevalence of NCP, as well as its management and association with QOL.

METHODS:

Cancer patients with pain ≥1 on the visual analogue scale (VAS) were surveyed with the Douleur Neuropathique (DN4) questionnaire, the Brief Pain Inventory-Short Form (BPI-SF), and the EuroQOL five dimensions (EQ-5D) questionnaire. The associations between NCP and pain severity or NCP and QOL, while controlling for variables relevant to QOL, were then analyzed.

RESULTS:

A total of 2003 patients were enrolled in this survey; the prevalence of NCP was 36.0% (n = 722, 95% CI, 32.5-39.5). We found that NCP in cancer patients was closely correlated to a higher pain severity (BPI-SF; 4.96 ± 1.94 versus 4.24 ± 2.02, p < 0.001), and in patients with NCP, pain more severely interfered with daily living, as compared to those without NCP (BPI-SF; 4.86 ± 2.71 versus 4.41 ± 2.87, p < 0.001). Patients with NCP also had worse QOL than those without NCP, as measured by EQ-5D index score (0.47 ± 0.30 vs. 0.51 ± 0.30, p = 0.005), and this was confirmed using multivariate analysis (p < 0.001), even after controlling for other variables such as age, sex, disease stage, cancer duration, radiotherapy, chemotherapy, and comorbidities. Importantly, adjuvant analgesics were used in less than half of patients with NCP (n = 358, 46.4%).

CONCLUSIONS:

We found that NCP in cancer patients was significantly associated with a worsened QOL, and current management is inadequate. Therefore, future research aimed at developing improved strategies for management of NCP is required.

KEYWORDS:

Neoplasm; Neuropathic pain; Pain management; Quality of life

PMID:
28689250
PMCID:
PMC5658461
DOI:
10.1007/s00520-017-3806-5
[Indexed for MEDLINE]
Free PMC Article

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