Neuropathic Pain in Gynecological Oncology Patients
Özet
Neuropathic pain may result from tumors, trauma, infection, toxins, metabolic, vascular, neurodegenerative, and autoimmune causes. Despite recent advancements in cancer treatment methods, neuropathic pain associated with cancer is widespread. Neuropathic cancer pain typically results from pressure on surrounding tissues from a growing tumor, tumor infiltration, or inflammation of surrounding tissues. In particular, in gynecological cancers, 60% of patients experience neuropathic pain as a result of brachial plexopathy, lumbosacral plexopathy, or panplexopathy due to tumor infiltration. Characteristics of neuropathic pain differ depending on the affected plexus. Pain is typically described as a burning and lightning-like sensation in the area corresponding to the dermatome. Lumbosacral plexopathy is common in gynecological cancers. The prognosis of patients with lumbosacral plexopathy is typically poor. Diagnosis of plexopathy pain involves techniques such as magnetic resonance imaging, computed tomography, positron emission tomography, and electromyography. Pain management includes radiation therapy, analgesics, and surgical tumor reduction. The etiology of chemotherapy-induced peripheral neuropathy varies depending on the agent used, the duration of administration, and the dose. Among the agents, oxaliplatin and cisplatin have the highest incidence. Coasting phenomena can occur even after these drugs are discontinued. Despite recent studies, no evidence-based treatment for peripheral neuropathy prevention is recommended in guidelines.
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