Unit:
Κατεύθυνση Αλγολογία: Αντιμετώπιση του πόνου, διάγνωση και θεραπεία. Φαρμακευτικές, παρεμβατικές και άλλες τεχνικέςLibrary of the School of Health Sciences
Supervisors info:
Ιωάννα Σιαφάκα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Αθηνά Βαδαλούκα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή ΕΚΠΑ
Ευμορφία Σταυροπούλου, Διευθύντρια ΕΣΥ, ΓΝ «ΚΑΤ»
Original Title:
Φαρμακευτική αντιμετώπιση του νευροπαθητικού πόνου σε ασθενείς με καρκίνο κεφαλής και τραχήλου μετά από ακτινοθεραπεία με ή χωρίς χημειοθεραπεία. Συστηματική βιβλιογραφική ανασκόπηση.
Translated title:
Pharmacological management of neuropathic pain in head and neck cancer patients receiving radiotherapy with or without chemotherapy. A Systematic Review
Summary:
Background: Neuropathic pain (NP) in head and neck cancer (HNC) patients represents a therapeutical challenge. Most of the studies concerning drugs used in NP are conducted in diabetic neuropathy or postherpetic neuralgia and data are limited to non-cancer pain. Regarding the cancer therapy- related NP, most of the studies do not focus on HNC patients. The aim of this review was to identify the studies about systematically administered medication for NP management that included HNC patients under radiotherapy or chemoradiotherapy.
Methods: A systematic literature search was performed, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in PubMed, Cochrane Library, Web of Science and ClinicalTrials.gov on 30 October 2021. The medical subject heading (MeSH) terms were “head and neck cancer” OR “tumor” AND “neuropathic pain” AND “medication” AND “radiotherapy.” Cochrane Collaboration tool was used for quality assessment.
Results: The search identified 432 articles. Three more articles were identified after searching the reference lists of the retrieved articles. A total of 10 articles met the eligibility inclusion criteria and were included in this review; 1 about pregabalin, 1 about nortriptyline, 1 about methadone, 1 about ketamine and 6 about gabapentin. Statistically significant results in pain reduction compared to placebo or standard pain medication were found in the studies concerning pregabalin (p=0.003), methadone (p=0.03), ketamine (p=0.012) and in 2 out of 6 gabapentin studies (p<0.004). Two of the studies (both concerning gabapentin) had no comparison arm.
Conclusions: Treatments including pregabalin, methadone, ketamine and gabapentin, were found to provide pain relief. While there is a plethora of pharmacological interventions available for the management of NP, only few studies have been conducted regarding the pharmacological management of therapy-related NP in HNC patients, including a small range of interventions. More studies should be conducted regarding the pharmacological approaches in HNC therapy related NP, so that specific treatment algorithms would be developed.
Main subject category:
Health Sciences
Keywords:
Neuropathic pain, Head and neck cancer, Radiotherapy, Pharmacological management
Number of references:
159
File:
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MSc thesis. neuropathic pain.pdf
2 MB
File access is restricted only to the intranet of UoA.
