The use of pregabalin in patients with neuropathic pain induced by radiotherapy – literature review Review article
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Published:
Mar 31, 2022
Keywords:
neuropathic pain, radiotherapy-induced peripheral neuropathy, pregabalin
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Abstract
Radiotherapy-induced neuropathy (RIPN) is an iatrogenic complication and a consequence of causal treatment of neoplastic disease. The risk of developing RIPN depends on the type of, but also on the patients’ factors. There is currently no proven method that can prevent the occurrence of RIPN, but modern radiotherapy techniques have reduced the risk of developing RIPN to about 1% of patients after irradiation. The most common symptoms in patients with RIPN are paraesthesia, hypoesthesia, and muscle weakness. Neuropathic pain may occur in around 50% of patients with RIPN and can only be treated symptomatically, both with pharmacotherapy and non-pharmacological methods. The recommended drugs are antiepileptics, antidepressants, opioid analgesics, and topical drugs. These drugs have proven their effectiveness in the population of patients with neuropathic pain unrelated to cancer treatment, but there are still no high-quality studies assessing their effectiveness in patients with RIPN. Randomized controlled studies available in the literature confirm the effectiveness of antiepileptics drugs in this group of patients, what is also observed in clinical practice.
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Kocot-Kępska , M. (2022). The use of pregabalin in patients with neuropathic pain induced by radiotherapy – literature review. Medycyna Faktow (J EBM), 15(1(54), 56-62. https://doi.org/10.24292/01.MF.0122.8
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References
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16. Kocot-Kępska M, Mańka-Matłok M. Miejsce pregabaliny i gabapentyny w leczeniu chorych z bólem neuropatycznym. Ból. 2020; 21(3): 1-15.
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18. Jiang J, Li Y, Shen Q et al. Effect of Pregabalin on Radiotherapy-Related Neuropathic Pain in Patients With Head and Neck Cancer: A Randomized Controlled Trial. J Clin Oncol. 2019; 37(2): 135-43. http://doi.org/10.1200/JCO.18.00896.
19. Charakterystyka produktu leczniczego: pregabalina.
20. Szczudlik A, Dobrogowski J, Wordliczek J et al. Diagnosis and management of neuropathic pain: Review of literature and recommendations of the Polish Association for the Study of Pain and the Polish Neurological Society – Part one. Neurol Neurochir Pol. 2014; 48: 262-71.
21. Lussier D. Pain Pharmacotherapy in Older Patients. In: Pain 2016: Refresher Courses, 16th World Congress on Pain.
22. Derry S, Bell RF, Straube S et al. Pregabalin for neuropathic pain in adults. Cochrane Database of Systematic Reviews 2019; 1: CD007076.
23. Markman JD, Jensen TS, Semel D et al. Effects of Pregabalin in Patients with Neuropathic Pain Previously Treated with Gabapentin: A Pooled Analysis of Parallel-Group, Randomized, Placebo-controlled Clinical Trials. Pain Pract. 2017; 17(6): 718-28. http://doi.org/10.1111/papr.12516.
24. Dworkin RH, O`Connor AB, Audette J et al. Recommendations for the pharmacological management of neuropathic pain; an overview and literature update. Mayo Clin Proc. 2010; 85(3 suppl): S3-S14.
25. Johnson P, Becker L, Halpern R et al. Real-world treatment of post-herpetic neuralgia with gabapentin or pregabalin. Clin Drug Investig. 2013; 33(1): 35-44.
26. Holbech JV, Jung A, Jonsson T et al. Combination treatment of neuropathic pain: Danish expert recommendations based on a Delphi process. J Pain Res. 2017; 10: 1467-75.
27. Arnold LM, McCarberg BH, Clair AG et al. Dose-response of pregabalin for diabetic peripheral neuropathy, postherpetic neuralgia, and fibromyalgia. Postgrad Med. 2017; 129(8): 921-33. http://doi.org/10.1080/00325481.2017.1384691.
2. Delanian S, Lefaix JL, Pradat PF. Radiation-induced neuropathy in cancer survivors. Radiother Oncol. 2012; 105(3): 273-82. http://doi.org/10.1016/j.radonc.2012.10.012.
3. Cai Z, Li Y, Hu Z et al. Radiation-induced brachial plexopathy in patients with nasopharyngeal carcinoma: A retrospective study. Oncotarget. 2016; 7: 18887-95.
4. Olsen NK, Pfeiffer P, Johannsen L et al. Radiation-induced brachial plexopathy: neurological follow-up in 161 recurrence-free breast cancer patients. Int J Radiat Oncol Biol Phys. 1993; 26(1): 43-9. http://doi.org/10.1016/0360-3016(93)90171-q.
5. Przeklasa-Muszyńska A, Dobrogowski J, Kocot-Kępska M. Kliniczna ocena chorego z bólem. In: Ból. Wiedza w kieszeni. Dobrogowski J, Wordliczek J, Kocot-Kępska M (ed). Termedia Wydawnictwa Medyczne, Poznań 2020: 25-34.
6. Delanian S, Lefaix J-L. Current management for late normal tissue injury: radiation-induced fibrosis and necrosis. Semin Radiat Oncol. 2007; 17: 99-107.
7. Delanian S, Lefaix J-L. The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway. Radiother Oncol. 2004; 73: 119-31.
8. Carl U, Feldmeier J, Schmitt G et al. Hyperbaric oxygen therapy for late sequelae in women receiving radiation after breast-conserving surgery. Int J Radiat Oncol Biol Phys. 2001; 49: 1029-31.
9. Evans M, Graham M, Mahler P et al. Use of steroids to suppress vascular response to radiation. Int J Radiat Oncol Biol Phys. 1987; 13: 563-7.
10. Fallon M, Giusti R, Aielli F et al; ESMO Guidelines Committee. Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2018; 29(suppl 4): iv166-iv191. http://doi.org/10.1093/annonc/mdy152.
11. Finnerup NB, Attal N, Haroutounian S et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015; 14(2): 162-73. http://doi.org/10.1016/S1474-4422(14)70251-0.
12. Fathers E, Thrush D, Huson SM et al. Radiation-induced brachial plexopathy in women treated for carcinoma of the breast. Clin Rehabil. 2002; 16: 160-5.
13. Doo AR, Shin YS, Yoo S et al. Radiation-Induced neuropathic pain successfully treated with systemic lidocaine administration. J Pain Res. 2018; 11: 545-8.
14. Mailly M, Benzakin S, Chauvin A et al. Radiation-induced head and neck pain: management with botulinum toxin a injections. Cancer Radiother. 2019; 23(4): 312-5.
15. Chincholkar M. Analgesic mechanisms of gabapentin and effects in experimental pain models: a narrative review. Br J Anaesth. 2018; 120: 1315-34.
16. Kocot-Kępska M, Mańka-Matłok M. Miejsce pregabaliny i gabapentyny w leczeniu chorych z bólem neuropatycznym. Ból. 2020; 21(3): 1-15.
17. Jordan RI, Mulvey MR, Bennett MI. A critical appraisal of gabapentinoids for pain in cancer patients. Curr Opin Support Palliat Care. 2018; 12(2): 108-17.
18. Jiang J, Li Y, Shen Q et al. Effect of Pregabalin on Radiotherapy-Related Neuropathic Pain in Patients With Head and Neck Cancer: A Randomized Controlled Trial. J Clin Oncol. 2019; 37(2): 135-43. http://doi.org/10.1200/JCO.18.00896.
19. Charakterystyka produktu leczniczego: pregabalina.
20. Szczudlik A, Dobrogowski J, Wordliczek J et al. Diagnosis and management of neuropathic pain: Review of literature and recommendations of the Polish Association for the Study of Pain and the Polish Neurological Society – Part one. Neurol Neurochir Pol. 2014; 48: 262-71.
21. Lussier D. Pain Pharmacotherapy in Older Patients. In: Pain 2016: Refresher Courses, 16th World Congress on Pain.
22. Derry S, Bell RF, Straube S et al. Pregabalin for neuropathic pain in adults. Cochrane Database of Systematic Reviews 2019; 1: CD007076.
23. Markman JD, Jensen TS, Semel D et al. Effects of Pregabalin in Patients with Neuropathic Pain Previously Treated with Gabapentin: A Pooled Analysis of Parallel-Group, Randomized, Placebo-controlled Clinical Trials. Pain Pract. 2017; 17(6): 718-28. http://doi.org/10.1111/papr.12516.
24. Dworkin RH, O`Connor AB, Audette J et al. Recommendations for the pharmacological management of neuropathic pain; an overview and literature update. Mayo Clin Proc. 2010; 85(3 suppl): S3-S14.
25. Johnson P, Becker L, Halpern R et al. Real-world treatment of post-herpetic neuralgia with gabapentin or pregabalin. Clin Drug Investig. 2013; 33(1): 35-44.
26. Holbech JV, Jung A, Jonsson T et al. Combination treatment of neuropathic pain: Danish expert recommendations based on a Delphi process. J Pain Res. 2017; 10: 1467-75.
27. Arnold LM, McCarberg BH, Clair AG et al. Dose-response of pregabalin for diabetic peripheral neuropathy, postherpetic neuralgia, and fibromyalgia. Postgrad Med. 2017; 129(8): 921-33. http://doi.org/10.1080/00325481.2017.1384691.