Treatment of variable pain syndrome in radiation therapy of bone metastases of breast cancer
https://doi.org/10.21518/2079-701X-2019-19-165-168
Abstract
Treatment of pain syndromes caused by bone metastases is a very important problem because of their prevalence in various tumor processes. The use of radiotherapy significantly alleviates pain, even in patients receiving strong opioids. However, at its initial stage, the pain may increase due to the inflammatory component. In this case, pathogenetically justified analgesics are non-steroidal anti-inflammatory drugs. It is reasonable to use them (in the absence of contraindications) in maximum doses with a subsequent gradual decrease, until complete discontinuation.
About the Authors
R. R. Sarmanayeva
P. A. Hertsen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of Russia
Russian Federation
Russian Federation
physician at the Palliative Care Center for Oncology
3, 2nd Botkinsky Ave., Moscow, 25834, Russia
G. R. Abuzarova
P. A. Hertsen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of Russia
Russian Federation
Russian Federation
Dr. of Sci. (Med), Head of the Palliative Care Centre,
3, 2nd Botkinsky Ave., Moscow, 25834, Russia
N. M. Bychkova
P. A. Hertsen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of Russia
Russian Federation
Russian Federation
к.м.н. заведующая дневным стационаром отдела лучевой терапии,
3, 2nd Botkinsky Ave., Moscow, 25834, Russia
G. S. Alexeeva
P. A. Hertsen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of Russia
Russian Federation
Russian Federation
Dr. of Sci. (Med), Deputy Director General for Clinical Work,
3, 2nd Botkinsky Ave., Moscow, 25834, Russia
References
1. Reale C., Turkiewicz A.M., Reale C.A. Analgic treatment of pain associated with bone metastases. Crit Rev Oncol Hematol. 2001;37(1):1-11. Available at: https://www.ncbi.nlm.nih.gov/pubmed/11164714.
2. Li B.T., Wong M.H., Pavlakis N., et al. Treatment and Prevention of Bone Metastases from Breast Cancer: A Comprehensive Review of Evidence for Clinical Practice. J Clin Med. 2014;3(1):1–24. doi: 10.3390/jcm3010001.
3. Wong M., Pavlakis N. Optimal management of bone metastases in breast cancer patients. Breast Cancer (Dove Med Press). 2011;3:35-60. doi: 10.2147/BCTT.S6655.
4. Mantyh P.W., Mechanisms of Malignant Bone pain. In: Cancer Pain. From Molecules to Saffering. Paice J.A., Bell R.F., Kalso E.A., Soyannwo O.A. IASP Press. Seattle; 2010:45-63.
5. Mantyh P.W., Clohisy D.R., Koltzenburg M., et al. Molecular mechanisms of cancer pain. Nature Reviews. Cancer. 2002;2(3):201-209. doi: 10.1038/nrc747.
6. Falk S., Dickenson A.H. Pain and nociception: mechanisms of cancer-induced bone pain. J Clin Oncol. 2014;32(16):1647-1654. doi: 10.1200/JCO.2013.51.7219.
7. Baron J.A. Epidemiology of non-steroidal antiinflammatory drugs and cancer. Prog Exp Tumor Res. 2003;37:1-24. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12795046.
8. Huang X.Z., Gao P., Sun J.X., et al. Aspirin and nonsteroidal anti-inflammatory drugs after but not before diagnosis are associated with improved breast cancer survival: a meta-analysis. Cancer Causes Control. 2015;26(4):589-600. doi: 10.1007/s10552-015-0539-y.
9. Malmberg A.B., Yaksh T.L. Pharmacology of the spinal action of ketorolac, morphine, ST-91, U50488H, and L-PIA on the formalin test and an isobolographic analysis of the NSAID interaction. Anesthesiology. 1993;79(2):270-281. doi: 10.1097/00000542-199308000-00012.
10. Fletcher D., Benoist J.M., Gautron M., Guilbaud G. Isobolographic analysis of interactions between intravenous morphine, propacetamol, and diclofenac in carrageenin-injected rats. Anesthesiology. 1997;87(2):317-326. doi: 10.1097/00000542-199708000-00019.
11. Ahmad I., Ahmed M.M., Ahsraf M.F., et al. Pain Management in Metastatic Bone Disease: A Literature Review. Cureus. 2018;10(9):e3286. doi: 10.7759/cureus.3286.
12. WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents World Health Organization 2018, Switzerland; 2019:41-50. Available at: https://www.who.int/ncds/management/palliative-сare/cancer-pain-guidelines/en/
13. Zaporowska-Stachowiak I., Łuczak J., Hoffmann K., Stachowiak K., Bryl W., Sopata M. Managing metastatic bone pain: New perspectives, different solutions. Biomed Pharmacother. 2017;93:1277-1284. doi: 10.1016/j.biopha.2017.07.023.
Review
For citations:
Sarmanayeva RR, Abuzarova GR, Bychkova NM, Alexeeva GS. Treatment of variable pain syndrome in radiation therapy of bone metastases of breast cancer. Meditsinskiy sovet = Medical Council. 2019;(19):165-168. (In Russ.) https://doi.org/10.21518/2079-701X-2019-19-165-168
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