Patarica-Huber, E., Boskov, N., & Pjevic, M. (2011). Multimodal approach to therapy-related neuropathic pain in breast cancer. Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology, 16(1), 40–45.http://www.ncbi.nlm.nih.gov/pubmed/21674848
To evaluate the effects of multimodal therapy on intensity and relief of treatment-related neuropathic pain in patients with breast cancer
This study consisted of 75 patients with breast cancer who were experiencing neuropathic pain randomly divided into three groups. Group 1 received gabapentin only, starting at 300 mg, titrated up to 3,600 mg/day until an adequate response was obtained. Group 2 received a constant dose of 1,200 mg gabapentin and 100 mg diclofen gradually titrated up. Group 3 received multimodal therapy including 900 mg gabapentin, 100 mg diclofen, and 60 mg M-Eslon. Additional medicine was allowed PRN.
A randomized, three-group, parallel study design was used.
Modified Brief Pain Inventory questionnaire (VAS/Likert scale)
Group 3 (which received the combination of three medications) achieved the highest level of pain relief; however, there was no significant difference between groups. There was a statistically significant drop in pain intensity for all groups. The largest decrease was achieved at time of the first visit. Side effects increased in intensity over time, and group 2 experienced the most intense side effects.
Multimodal therapy seems to have some benefit on neuropathic pain in patients with breast cancer.
Patients with breast cancer would appear to benefit from multimodal therapy including different drugs and dosages to treat their neuropathic pain. Nurses should watch for an increase in side effects at subsequent follow-up visits.