Chemotherapy-induced neuropathic pain characteristics in Mexico’s National Cancer Center pain clinic

Abstract

Ulises Coffeen,1 Marco Antonio Sotomayor-Sobrino,2,3 Ariadna Jiménez-González,2,3 Luis Gerardo Balcazar-Ochoa,3 Pamela Hernández-Delgado,3 Ana Fresán,1 Ricardo Plancarte-Sanchez,4 Samantha Daniela Arias-Muñóz,5 Abraham Ochoa-Aguilar2,61Laboratorio de Neurofisiología Integrativa. Investigaciones en Neurociencias y División de Investigación Clínica, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Clinical Research Division, Mexico City, Mexico; 2Hospital Loma Linda, Translational Research Laboratory, Naucalpan, Mexico; 3Universidad Nacional Autónoma de México, Faculty of Medicine, Mexico City, Mexico; 4Instituto Nacional de Cancerología, Clínica de dolor, Tlalpan, Mexico; 5Universidad Anahuac Norte, Faculty of Medicine, Huixquilucan Mexico, Huixquilucan, Mexico; 6Universidad La Salle, Mexican Faculty of Medicine, Mexico City, MexicoIntroduction: Chemotherapy (CT) is one of the most commonly used pharmacological approaches in cancer treatment. However, CT induces damage to several tissues causing significant deleterious effects in cancer survivors being chemotherapy-induced neuropathic pain (CINP) among the most commonly reported. CINP is thought to be present in up to 68.1% of the patients within 1 month of receiving CT. Due to the fact that reliable statistic information is scarce in several Latin American countries’ diagnosis and treatment of this side-effect may be delayed directly affecting patients. Therefore, the aim of the present study was to determine and present the incidence and features of CINP in patients with cancer attending the Pain Management Clinic at Mexicos’ National Institute of Cancerology in Mexico City.Methods: We performed a retrospective, file-based analysis of all the patients treated in the Pain Management Clinic at the National Institute at Cancer in Mexico from January 2016 to January 2017.Results: CINP was found in 30.9% of the patients. The basal VAS was on average 2.5 upon arrival to the Pain Management Unit and 2.4 at the end of treatment (p>0.05). The patients with the highest risk of developing CINP were those treated with paclitaxel Odds ratio 8.3 (p<0.01), followed by platins OR 4 (p<0.01), vincristine OR 1.5 (p=0.01) and thalidomide OR 1.1 (p=0.01).Conclusion: Incidence of CINP was similar to previous reports; however, the number of variables related to this type of pain in our cohort may open a new line of research and highlight the importance of this particular issue to our health system. It is necessary to develop a mechanism to predict the risk of patients to suffer CINP and to search the mechanism to control and reduce the suffering related to the current treatments.Keywords: Pain, chemotherapy, neuropathy, paclitaxel

Keywords

• Pain
• Chemotherapy
• Neuropathy
• Paclitaxel