Abstract
Objective
To summarises 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 search from inception to January 2019. Data were extracted and synthesised 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 pin‐prick 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 characterising 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 individualised analgesic treatment choices.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/34f3q70
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