Aproximación al manejo del dolor en la enfermedad ósea metastásica.

Approach to the management of pain in metastatic bone disease.

Contenido principal del artículo

Ana Antolínez P.
Pedro Pérez S.
Diego González R.
Resumen

Introducción: La enfermedad ósea metastásica es una condición frecuente y devastadora para el enfermo oncológico en términos de disminución de la funcionalidad, autonomía, dolor y reducción de la calidad de vida. El dolor óseo secundario a enfermedad metastásica tiene una etiología multifactorial compleja y se considera de difícil manejo. A pesar de la existencia de múltiples herramientas terapéuticas para esta condición, persiste un grupo importante de pacientes que no reciben un manejo optimizado de dolor. Objetivos: El objetivo de este artículo es revisar las diferentes estrategias para el manejo del dolor óseo secundario a enfermedad metastásica. Materiales y métodos: Se realizó una búsqueda de la literatura en PubMed, ScienceDirect y MD Consult, con palabras MeSH y texto libre a partir de 1989. Se obtuvieron 211 artículos y se seleccionaron 80 por su relevancia. Conclusiones: El dolor óseo en la enfermedad ósea metastásica se considera de etiología multifactorial y de difícil manejo; existen diferentes estrategias terapéuticas para su tratamiento, recomendándose la aplicación de la analgesia multimodal. El especialista en dolor tiene un papel fundamental en la orientación del manejo no solamente farmacológico, sino en la estructuración de un tratamiento multidisciplinario coordinado encaminado al logro de los objetivos.

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Biografía del autor/a (VER)

Ana Antolínez P., Asociación Colombiana de Hematología y Oncología

Especialista en entrenamiento de Medicina del Dolor y Cuidados Paliativos, Universidad Militar Nueva Granada, Instituto Nacional de Cancerología (Bogotá, Colombia).

Pedro Pérez S., Asociación Colombiana de Hematología y Oncología

Especialista en entrenamiento de Medicina del Dolor y Cuidados Paliativos, Universidad Militar Nueva Granada, Instituto Nacional de Cancerología (Bogotá, Colombia).

Diego González R., Asociación Colombiana de Hematología y Oncología

Especialista en entrenamiento de Medicina del Dolor y Cuidados Paliativos, Universidad Militar Nueva Granada, Instituto Nacional de Cancerología (Bogotá, Colombia).

Referencias

Damron T. Oncology and basic science. (s. l.): Lippincott Williams & Wilkins; 2008.

Pachman DR, Barton DL, Swetz KM, Loprinzi CL. Troublesome symptoms in cancer survivors: fatigue, insomnia, neuropathy, and pain. J Clin Oncol 2012;30(30):3687-96.

Van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 2007;18(9):1437-49.

Goudas LC, Bloch R, Gialeli-Goudas M, Lau J, Carr DB. The epidemiology of cancer pain. Cancer Invest 2005;23(2):182-90.

Epidemiología del dolor provocado por el cáncer. IASP Año Global del Dolor Producido por el Cáncer 2008-2009. Disponible en: http://www.iasppain.org/files/Content/ContentFolders/GlobalYearAgainstPain2/MusculoskeletalPainFactSheets/Epidemiology_Spanish.pdf

Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart JA, et al. Pain and its treatment in outpatients with metastatic cancer. N Engl J Med 1994;330(9):592-6.

Mercadante S. Malignant bone pain: pathophysiology and treatment. Pain 1997;69(1-2):1-18.

Gear RW, Miaskowski C, Gordon NC, Paul SM, Heller PH, Levine JD. Kappa-opioids produce significantly greater analgesia in women than in men. Nat Med 1996;2(11):1248-50.

World Health Organization. Palliative care: symptom management and end-of-life care: interim guidelines for first-level facility health workers. Geneva; 2004.

Hoskin P. Opioids in context: relieving the pain of cancer. The role of comprehensive cancer management. Palliat Med 2008;22(4):303-9.

Cleeland CS, Janjan NA, Scott CB, Seiferheld WF, Curran WJ. Cancer pain management by radiotherapists: a survey of radiation therapy oncology group physicians. Int J Radiat Oncol Biol Phys 2000;47(1):203-8.

Dalal S, Bruera E. Access to opioid analgesics and pain relief for patients with cancer. Nat Rev Clin Oncol 2013;10(2):108-16.

Pain and Policy Studies Group. Disponibilidad de analgésicos opioides en las Américas y en el mundo. University of Wisconsin Pain and Policy studies Group/WHO Collaboratin Center for Policy and Communications in Cancer Care, Madison, Wisconsin, EE. UU. Preparado para el I Congreso de la Asociación Latinoamericana de Cuidados Paliativos, VII Curso Latinoamericano de Medicina y Cuidados Paliativos, Guadalajara, México, 20-22 marzo 2002 (Monograph).

Harris K, Li K, Flynn C, Chow E. Worst, average or current pain in the Brief Pain Inventory: which should be used to calculate the response to palliative radiotherapy in patients with bone metastases? Clin Oncol (R Coll Radiol) 2007;19(7):523-7.

Langford DJ, Tripathy D, Paul SM, West C, Dodd MJ, Schumacher K, et al. Trajectories of pain and analgesics in oncology outpatients with metastatic bone pain. J Pain 2011;12(4):495-507.

Cleeland CS. The measurement of pain from metastatic bone disease: capturing the patient’s experience. Clin Cancer Res 2006;12:6236s-6242s.

Puebla F. Tipos de dolor y escala terapéutica de la OMS. Dolor iatrogénico. Oncología 2005;28(3):139-43.

Mantyh PW. Substance P and the inflammatory and immune response. Ann N Y Acad Sci 1991;632:263-71.

Mantyh PW. Un enfoque mecanístico del dolor oncológico. Rev Soc Esp Dolor 2002;9:481-4.

Honore P, Rogers SD, Schwei MJ, Salak-Johnson JL, Luger NM, Sabino MC, et al. Murine models of inflammatory, neuropathic and cancer pain each generates a unique set of neurochemical changes in the spinal cord and sensory neurons. Neuroscience 2000;98(3):585-98.

Mercadante S, Arcuri E. Breakthrough pain in cancer patients: pathophysiology and treatment. Cancer Treat Rev 1998;24(6):425-32.

Nagy I, Rang H. Noxious heat activates all capsaicin-sensitive and also a sub-population of capsaicin-insensitive dorsal root ganglion neurons. Neuroscience 1999;88(4):995-7.

Basbaum AI. Immediate-early genes and pain: what’s all the ‘Fos’ about? APS J 1994;3:49-52.

Armstrong AJ, Creel P, Turnbull J, Moore C, Jaffe TA, Haley S, et al. A phase I-II study of docetaxel and atrasentan in men with castration-resistant metastatic prostate cancer. Clin Cancer Res 2008;14(19):6270-6.

Quinn DI, Tangen CM, Hussain M, Lara PN Jr, Goldkorn A, Moinpour CM, et al. Docetaxel and atrasentan versus docetaxel and placebo for men with advanced castration-resistant prostate cancer (SWOG S0421): a randomised phase 3 trial. Lancet Oncol 2013;14(9):893-900.

Muralidharan A, Smith MT. Pathobiology and management of prostate cancer-induced bone pain: recent insights and future treatments. Inflammopharmacol 2013;21(5):339-63.

Mach DB, Rogers SD, Sabino MC, Luger NM, Schwei MJ, Pomonis JD, et al. Origins of skeletal pain: sensory and sympathetic innervation of the mouse femur. Neuroscience 2002;113(1):155-66.

Mantyh P. Pathophysiology of bone cancer pain. Pain an Update Review 2005.

Hoskin PJ, Ford HT, Harmer CL. Hemibody irradiation (HBI) for metastatic bone pain in two histological distinct groups of patients. Clin Oncol (R Coll Radiol) 1989;1(2):67-9.

Hoskin PJ, Stratford MR, Folkes LK, Regan J, Yarnold JR. Effect of local radiotherapy for bone pain on urinary markers of osteoclast activity. Lancet 2000;355(9213):1428-9.

Janjan N, Lutz ST, Bedwinek JM, Hartsell WF, Ng A, Pieters RS Jr, et al. Therapeutic guidelines for the treatment of bone metastasis: a report from the American College of Radiology Appropriateness Criteria Expert Panel on Radiation Oncology. J Palliat Med 2009;12(5):417-26.

McQuay HJ, Collins S, Carroll D, Moore RA. Radiotherapy for the palliation of painful bone metastases. Cochrane Database Syst Rev 2000;(2):CD001793.

Lutz ST, Chow EL, Hartsell WF, Konski AA. A review of hypofractionated palliative radiotherapy. Cancer 2007;109(8):1462-70.

Pal S, Dutta S, Adhikary SS, Bhattacharya B, Ghosh B, Patra NB. Hemi body irradiation: an economical way of palliation of pain in bone metastasis in advanced cancer. South Asian J Cancer 2014;3(1):28-32.

Dupuy DE, Liu D, Hartfeil D, Hanna L, Blume JD, Ahrar K, et al. Percutaneous radiofrequency ablation of painful osseous metastases: a multi-center American College of Radiology Imaging Network trial. Cancer 2010;116(4):989-97.

Goetz MP, Callstrom MR, Charboneau JW, Farrell MA, Maus TP, Welch TJ, et al. Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol 2004;22(2):300-6.

Nabal M, Librada S, Redondo MJ, Pigni A, Brunelli C, Caraceni A. The role of paracetamol and nonsteroidal anti-inflammatory drugs in addition to WHO Step III opioids in the control of pain in advanced cancer. A systematic review of the literature. Palliat Med 2012;26(4):305-12.

Mercadante S, Giarratano A. The long and winding road of non steroidal antinflammatory drugs and paracetamol in cancer pain management: a critical review. Crit Rev Oncol Hematol 2013;87(2):140-5.

Moselli NM, Cruto M, Massucco P, Savojardo M, Debernardi F. Long-term continuous subcutaneous infusion of ketoprofen combined with morphine: a safe and effective approach to cancer pain. Clin J Pain 2010;26(4):267-74.

McNicol E, Strassels SA, Goudas L, Lau J, Carr DB. NSAIDS or paracetamol, alone or combined with opioids, for cancer pain. Cochrane Database Syst Rev 2005;(1):CD005180.

McQuay HJ, Carroll D, Glynn CJ. Low dose amitriptyline in the treatment of chronic pain. Anaesthesia 1992;47(8):646-52.

Sindrup SH, Jensen TS. Efficacy of pharmacological treatments of neurophatic pain: an update and effect related to mechanism of drug action. Pain 1999;83(3):389-400.

Sindrup SH, Bach FW, Madsen C, Gram LF, Jensen TS. Venlafaxine versus imipramine in painful polyneuropathy: a randomized, controlled trial. Neurology 2003;60(8):1284-9.

McQuay HJ, Tramer M, Nye BA, Carroll D, Wiffen PJ, Moore RA. A systematic review of antidepressants in neuropathic pain. Pain 1996;68(2-3):217-27.

Krafft RM. Trigeminal neuralgia. Am Fam Physician 2008;77(9):1291-6.

Buescher JJ. Carbamazepine for acute and chronic pain. Am Fam Physician 2006;73(9):1549-50.

Finnerup NB, Sindrup SH, Jensen TS. The evidence for pharmacological treatment of neuropathic pain. Pain 2010;150(3):573-81.

Arai YC, Matsubara T, Shimo K, Suetomi K, Nishihara M, Ushida T, et al. Low-dose gabapentin as useful adjuvant to opioids for neuropathic cancer pain when combined with low-dose imipramine. J Anesth 2010;24(3):407-10.

Nishihara M, Arai YC, Yamamoto Y, Nishida K, Arakawa M, Ushida T, et al. Combinations of low-dose antidepressants and lowdose pregabalin as useful adjuvants to opioids for intractable, painful bone metastases. Pain Physician 2013;16(5):E547-52.

Bell RF, Eccleston C, Kalso EA. Ketamine as an adjuvant to opioids for cancer pain. Cochrane Database Syst Rev 2012;11:CD003351.

Koyyalagunta D, Bruera E, Solanki DR, Nouri KH, Burton AW, Toro MP, et al. A systematic review of randomized trials on the effectiveness of opioids for cancer pain. Pain Physician 2012;15:ES39-58.

Riley J, Branford R, Droney J, Gretton S, Sato H, Kennett A, et al. Morphine or oxycodone for cancer-related pain? A randomized, open-label, controlled trial. J Pain Symptom Manage 2015;49(2):161-72.

Kress HG, Koch ED, Kosturski H, Steup A, Karcher K, Lange B, et al. Tapentadol prolonged release for managing moderate to severe, chronic malignant tumor-related pain. Pain Physician 2014;17(4):329-43.

Wiffen PJ, Wee B, Moore RA. Oral morphine for cancer pain. Cochrane Database Syst Rev 2013;7:CD003868.

Coluzzi PH, Schwartzberg L, Conroy JD, Charapata S, Gay M, Busch MA, et al. Breakthrough cancer pain: a randomized trial comparing oral transmucosal fentanyl citrate (OTFC) and morphine sulfate immediate release (MSIR). Pain 2001;91(1-2):123-30.

Zeppetella G, Davies AN. Opioids for the management of breakthrough pain in cancer patients. Cochrane Database Syst Rev 2013;10:CD004311.

Webster LR, Slevin KA, Narayana A, Earl CQ, Yang R. Fentanyl buccal tablet compared with immediate-release oxycodone for the management of breakthrough pain in opioid-tolerant patients with chronic cancer and noncancer pain: a randomized, double-blind, crossover study followed by a 12-week open-label phase to evaluate patient outcomes. Pain Med 2013;14(9):1332-45.

Loftus LS, Edwards-Bennett S, Sokol GH. Systemic therapy for bone metastases. Cancer Control 2012;19(2):145-53.

Iranikhah M, Stricker S, Freeman MK. Future of bisphosphonates and denosumab for men with advanced prostate cancer. Cancer Manag Res 2014;6: 217-24.

Fizazi K, Carducci M, Smith M, Damião R, Brown J, Karsh L, et al. Denosumab versus zoledronic acid for treatment of bone metastases in men with castration-resistant prostate cancer: a randomised, double-blind study. Lancet 2011;377(9768):813-22.

Stopeck AT, Lipton A, Body JJ, Steger GG, Tonkin K, de Boer RH, et al. Denosumab compared with zoledronic acid for the treatment of bone metastases in patients with advanced breast cancer: a randomized, double-blind study. J Clin Oncol 2010;28(35):5132-9.

Henry DH, Costa L, Goldwasser F, Hirsh V, Hungria V, Prausova J, et al. Randomized, double-blind study of denosumab versus zoledronic acid in the treatment of bone metastases in patients with advanced cancer (excluding breast and prostate cancer) or multiple myeloma. J Clin Oncol 2011;29(9):1125-32.

Pavlakis N, Schmidt RL, Stockler M. Bifosfonatos para el cáncer de mama (revisión Cochrane traducida). Biblioteca Cochrane Plus 2006;(2). Oxford: Update Software Ltd. Disponible en: http://www.update-software.com (Traducida de The Cochrane Library 2006;(2). Chichester, UK: John Wiley & Sons, Ltd.).

Barrett-Lee P, Casbard A, Abraham J, Hood K, Coleman R, Simmonds P, et al. Oral ibandronic acid versus intravenous zoledronic acid in treatment of bone metastases from breast cancer: a randomised, open label, non-inferiority phase 3 trial. Lancet Oncol 2014;15(1):114-22.

Amadori D, Aglietta M, Alessi B, Gianni L, Ibrahim T, Farina G, et al. Efficacy and safety of 12-weekly versus 4-weekly zoledronic acid for prolonged treatment of patients with bone metastases from breast cancer (ZOOM): a phase 3, open-label, randomised, non-inferiority trial. Lancet Oncol 2013;14(7):663-70.

Smith MR, Halabi S, Ryan CJ, Hussain A, Vogelzang N, Stadler W, et al. Randomized controlled trial of early zoledronic acid in men with castration-sensitive prostate cancer and bone metastases: results of CALGB 90202 (alliance). J Clin Oncol 2014;32(11):1143-50.

Hillegonds DJ, Franklin S, Shelton DK, Vijayakumar S, Vijayakumar V. The management of painful bone metastases with an emphasis on radionuclide therapy. J Natl Med Assoc 2007;99(7):785-94.

Pandit-Taskar N, Batraki M, Divgi CR. Radiopharmaceutical therapy for palliation of bone pain from osseous metastases. J Nucl Med 2004;45(8):1358-65.

Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, FossåSD, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med 2013;369(3):213-23.

Suominen MI, Rissanen JP, Kakonen R, Fagerlund KM, Alhoniemi E, Mumberg D, et al. Survival benefit with radium-223 dichloride in a mouse model of breast cancer bone metastasis. J Natl Cancer Inst 2013;105(12):908-16.

Oosterhof GO, Roberts JT, de Reijke TM, Engelholm SA, Horenblas S, von der Maase H, et al. Strontium (89) chloride versus palliative local field radiotherapy in patients with hormonal escaped prostate cancer: a phase III study of the European Organisation for Research and Treatment of Cancer, Genitourinary Group. Eur Urol 2003;44(5):519-26.

Tu SM, Millikan RE, Mengistu B, Delpassand ES, Amato RJ, Pagliaro LC, et al. Bone-targeted therapy for advanced androgenindependent carcinoma of the prostate: a randomised phase II trial. Lancet 2001;357(9253):336-41.

Sartor O, Reid RH, Hoskin PJ, Quick DP, Ell PJ, Coleman RE, et al. Samarium-153-Lexidronam complex for treatment of painful bone metastases in hormone-refractory prostate cancer. Urology 2004;63(5):940-5.

Fuster D, Herranz D, Vidal-Sicart S, Muñoz M, Conill C, Mateos JJ, et al. Usefulness of strontium-89 for bone pain palliation in metastatic breast cancer patients. Nucl Med Commun 2000;21(7):623-6.

Baczyk M, Czepczynski R, Milecki P, Pisarek M, Oleksa R, Sowinski J. 89Sr versus 153Sm-EDTMP: comparison of treatment efficacy of painful bone metastases in prostate and breast carcinoma. Nucl Med Commun 2007;28(4):245-50.

Fuster D, Herranz D, Vidal-Sicart S, Muñoz M, Conill C, Mateos JJ, et al. Usefulness of strontium-89 for bone pain palliation in metastatic breast cancer patients. Nucl Med Commun 2000;21(7):623-6.

Sciuto R, Festa A, Pasqualoni R, Semprebene A, Rea S, Bergomi S, et al. Metastatic bone pain palliation with 89-Sr and 186-Re-HEDP in breast cancer patients. Breast Cancer Res Treat 2001;66(2):101-9.

Englaro EE, Schroder LE, Thomas SR, Williams CC, Maxon HR 3rd. Safety and efficacy of repeated sequential administrations of Re-186(Sn)HEDP as palliative therapy for painful skeletal metastases. Initial case reports of two patients. Clin Nucl Med 1992;17(1):41-4.

Sartor O, Reid RH, Hoskin PJ, Quick DP, Ell PJ, Coleman RE, et al. Samarium-153-Lexidronam complex for treatment of painful bone metastases in hormone-refractory prostate cancer. Urology 2004;63(5):940-5.

Rubini G, Nicoletti A, Rubini D, Asabella AN. Radiometabolic treatment of bone-metastasizing cancer: from 186rhenium to 223radium. Cancer Biother Radiopharm 2014;29(1):1-11.

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