Novel Techniques of Radiotherapy in the Management of Oncologic Pain

Authors

DOI:

https://doi.org/10.59679/LAPC20230041

Keywords:

Pain, Analgesia, Radiotherapy Internal-External Control, Overall Survival

Abstract

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Oncologic pain (OP), in general, increases with disease progression. Moderate or severe intensity OP occurs in around 30% of cancer patients receiving treatment and in 60% to 90% of patients with advanced cancer. Radiotherapy  (RT)  is an effective non-pharmacological method of treatment of OP. Two new techniques of RT are available for pain control: ablative RT for oligometastatic disease and lattice RT, for voluminous tumors. We will review their efficacy and results, concluding that OP is a complex biologic phenomenon and its  successful treatment  requires careful assessment of its nature, understanding the different types and patterns. Specific pain management with new radiation techniques can be effective and provide good pain control, allowing the reduction of analgesics use, improving the quality of life.

References

Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, Keefe FJ, Mogil JS, Ringkamp M, Sluka KA, Song XJ, Stevens B, Sullivan MD, Tutelman PR, Ushida T, Vader K. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020 Sep 1;161(9):1976-1982.

Hickey M, Barry D, Redito J, Anand N, Bianchi N, Reneman M, Escorpizo R. Content validity of patient-reported outcome measures for patients with chronic pain: considering the patient’s perspective. Pain. 2023 Feb 1;164(2):252-257.

Fillingim RB. Individual Differences in Pain: Understanding the Mosaic that Makes Pain Personal Pain. 2017 Apr; 158(Suppl 1): S11–S18.

Chwistek M. Recent advances in understanding and managing cancer pain. F1000 Res. 2017 Jun 20;6:945.

Kumar SP. Cancer Pain: A Critical Review of Mechanism-based Classification and Physical Therapy Management in Palliative Care. Indian J Palliat Care. 2011 May;17(2):116-26.

Zajączkowska R, Leppert W. Treatment of neuropathic pain in cancer patients. Palliat Med Pract 2016; 10: 14-21.

van den Beuken-van Everdingen MH, Hochstenbach LM, Joosten EA, Tjan-Heijnen VC, Janssen DJ. Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis. J Pain Symptom Manage. 2016 Jun;51(6):1070-1090.e9.

Leppert W, Zajaczkowska R, Wordliczek J, Dobrogowski J, Woroń J, Krzakowski M. Pathophysiology and clinical characteristics of pain in most common locations in cancer patients. J Physiol Pharmacol 2016; 67: 787-799.

Hendrickx TC, Barbeau LMO, Giuranno L, Dams G, Ient J, Olivo Pimentel V, van Gisbergen MW, Dubois LJ, Vooijs MA. HIF-1α and HIF-2α Differently Regulate the Radiation Sensitivity of NSCLC Cells. Cells. 2019 Jan 12;8(1):45.

Iezzi R, Kovács G, Dimov V, Contegiacomo A, Posa A, Efthymiou E, Lancellotta V, Rodolfino E, Punzi E, Trajkovski ZB, Valentini V, Manfredi R, Filippiadis D. Multimodal locoregional procedures for cancer pain management: a literature review. Br J Radiol. 2022 Nov 25:20220236.

Pacifico P, Colciago RR, De Felice F, Boldrini L, Salvestrini V, Nardone V, Desideri I, Greco C, Arcangeli S. A critical review on oligometastatic disease: a radiation oncologist’s perspective. Med Oncol. 2022 Sep 7;39(12):181.

Palacios-Eito A, García-Cabezas S. Oligometastatic disease, the curative challenge in radiation oncology. World J Clin Oncol. 2015 Aug 10;6(4):30-4.

Hellman S, Weichselbaum RR. Radiation oncology and the new biology. Cancer J Sci Am. 1995 Sep-Oct;1(3):174-9.

Sia J, Szmyd R, Hau E, Gee HE. Molecular Mechanisms of Radiation- Induced Cancer Cell Death: A Primer. Front Cell Dev Biol. 2020 Feb 13;8:41.

Sun B, Brooks ED, Komaki R, Liao Z, Jeter M, McAleer M, Balter PA, Welsh JD, O’Reilly M, Gomez D, Hahn SM, Sepesi B, Rice DC, Heymach JV, Chang JY. Long-Term Outcomes of Salvage Stereotactic Ablative Radiotherapy for Isolated Lung Recurrence of Non-Small Cell Lung Cancer: A Phase II Clinical Trial. J Thorac Oncol. 2017 Jun;12(6):983-992.

Arcidiacono F, Anselmo P, Casale M, Zannori C, Ragusa M, Mancioli F, Marchetti G, Loreti F, Italiani M, Bracarda S, Maranzano E, Trippa F. STereotactic Ablative RadioTherapy in NEWly Diagnosed and Recurrent Locally Advanced Non-Small Cell Lung Cancer Patients Unfit for ConcurrEnt RAdio Chemotherapy: Early Analysis of the START NEW-ERA Non-Randomised Phase II Trial. Int J Radiat Oncol Biol Phys. 2022 Oct 24:S03603016(22)03459-9.

Harrow S, Palma DA, Olson R, et al. Stereotactic Radiation for the Comprehensive Treatment of Oligometastases (SABR-COMET)— extended long-term outcomes. Int J Radiat Oncol Biol Phys. 2022;S0360–3016(22):00412–416.

Moreno Roig E, Groot AJ, Yaromina A, Hendrickx TC, Barbeau LMO, Giuranno L, Dams G, Ient J, Olivo Pimentel V, van Gisbergen MW, Dubois LJ, Vooijs MA. HIF-1α and HIF-2α Differently Regulate the Radiation Sensitivity of NSCLC Cells. Cells. 2019 Jan 12;8(1):45.

Pellizzon ACA. Lattice radiation therapy - its concept and impact in the immunomodulation cancer treatment era. Rev Assoc Med Bras (1992). 2020 Jun;66(6):728-731.

Amendola BE, Perez NC, Wu X, Amendola MA, Qureshi IZ. Safety and Efficacy of Lattice Radiotherapy in Voluminous Non-small Cell Lung Cancer. Cureus. 2019 Mar 18;11(3):e4263.

Paice JA, Mulvey M, Bennett M, Dougherty PM, Farrar JT, Mantyh PW, Miaskowski C, Schmidt B, Smith TJ. AAPT Diagnostic Criteria

for Chronic Cancer Pain Conditions. J Pain. 2017 Mar;18(3):233-246.

Brown MR, Ramirez JD: Neuroimmune mechanisms in cancer pain. Curr Opin Support Palliat Care. 2015;9(2):103–11.

Downloads

Published

2023-12-29 — Updated on 2024-01-10

Versions

صندلی اداری سرور مجازی ایران Decentralized Exchange

Issue

Section

Brief Communication