Pain in malignant pleural mesothelioma: a prospective characterization study

MacLeod, N., Kelly, C. , Stobo, J. , McMahon, L., Taggart, D., Fallon, M. and Laird, B. J. (2016) Pain in malignant pleural mesothelioma: a prospective characterization study. Pain Medicine, 17(11), pp. 2119-2126. (doi: 10.1093/pm/pnw061) (PMID:27117437)

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INTRODUCTION: Malignant pleural mesothelioma (MPM) is associated with severe pain. The underlying neurobiology of this is complex. The primary aim of this study was to characterize pain in MPM. METHODS: This study was undertaken as part of a trial examining radiotherapy for the treatment of pain in MPM (ISRCTN 10644347). Patients had MPM with associated pain for which radiotherapy was planned and a worst pain score ≥ 4/10. The following assessments were undertaken: clinical neuropathic pain assessment, Brief Pain Inventory (BPI), Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Short form of the McGill Pain Questionnaire (SF-MPQ), and Quantitative Sensory Testing (QST). The relationship of these characteristics and response to radiotherapy was assessed. Unless stated, medians and interquartile range (IQR) are used. RESULTS: Thirty-seven patients were recruited. Average pain and worst pain was 4 (4-6) and 8 (6-8), respectively. Higher average pain and higher worst pain scores were associated with higher interference scores on the BPI, P < 0.001 and P < 0.0005. Twenty patients (54%) had a clinical diagnosis of neuropathic pain, and of these, only six patients (40%) screened positively for neuropathic pain using the LANSS. Patients with a high LANSS also had higher BPI and SF-MPQs. The presence of neuropathic pain (clinically or by LANSS) did not predict response to radiotherapy, P < 0.05. The SF-MPQ scores were higher in those with abnormal cool sensation on QST (P = 0.016). CONCLUSION: Pain in mesothelioma varies among patients and may have neuropathic components. An adequate pain assessment is necessary to guide the clinician in the appropriate choice of analgesics.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Taggart, Miss Diann and Kelly, Mrs Caroline and Stobo, Mr Jon
Authors: MacLeod, N., Kelly, C., Stobo, J., McMahon, L., Taggart, D., Fallon, M., and Laird, B. J.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Pain Medicine
Publisher:Oxford University Press
ISSN (Online):1526-4637
Published Online:26 April 2016

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