Abstract
Purpose
Tumor-related cancer pain often comprises mixed pain with both nociceptive and neuropathic components. Whether tumor-related cancer pain includes a neuropathic component impacts the therapeutic strategy. The aim of this cross-sectional study was to investigate the usefulness of two screening tools for neuropathic pain, painDETECT and Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), in identifying the neuropathic component of mixed pain among patients with tumor-related cancer pain.
Method
This cross-sectional study recruited consecutive inpatients and outpatients at a single site. The diagnostic accuracy of painDETECT and S-LANSS was evaluated using receiver operating characteristic curve analysis and classification probability.
Results
Of the study group, 106 patients had tumor-related cancer pain. Analyses of the nociceptive and mixed pain groups (n = 104) showed that neither painDETECT nor S-LANSS had satisfactory areas under the curve (AUCs) for identifying the neuropathic component of mixed pain (0.59 for painDETECT and 0.56 for S-LANSS). By pain intensity, the AUC for painDETECT was significantly higher in the mild pain group than in the moderate or severe pain group (0.77 vs. 0.43, P = 0.002). All parameters of classification probability for both tools were higher in the mild pain group than in the moderate or severe pain group.
Conclusions
painDETECT and S-LANSS could not identify the neuropathic component of mixed pain among patients with tumor-related cancer pain, especially when pain was moderate or severe. Contrarily, these screening tools might be useful for identifying the neuropathic component of mixed pain for mild pain.
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Acknowledgments
We thank Ms. Masako Ikeda and Ms. Sachiko Nagatsuma at the Department of Palliative medicine, National Cancer Center Hospital East for their secretarial support.
Funding
This work was supported by a grant from Daiwa Securities Health Foundation.
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This study was conducted in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines. The study was approved by the National Cancer Center’s institutional review board. All participants provided written informed consent.
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Higashibata, T., Tagami, K., Miura, T. et al. Usefulness of painDETECT and S-LANSS in identifying the neuropathic component of mixed pain among patients with tumor-related cancer pain. Support Care Cancer 28, 279–285 (2020). https://doi.org/10.1007/s00520-019-04819-9
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DOI: https://doi.org/10.1007/s00520-019-04819-9