关于癌痛机制与治疗方法的研究现状: 一项系统性综述
Current Research Status on the Mechanisms and Treatment Methods of Cancer Pain: A Systematic Review
DOI: 10.12677/acm.2026.1672565, PDF,   
作者: 姬甜甜, 高彦东*, 边步荣:延安大学医学院,陕西 延安
关键词: 癌性疼痛机制治疗方法Cancer Pain Mechanism Treatment Methods
摘要: 癌痛(cancer pain)是癌症患者因肿瘤本身发展、转移或治疗过程引发的持续性或间歇性疼痛,作为癌症患者的主要症状,普遍存在于癌症患者的每个阶段,困扰着大部分癌症患者,已经成为影响癌症患者生存质量和生存期的关键问题之一。据研究显示,对于晚期癌症患者,至少66%的患者会出现疼痛,且55%的患者会经历中度至重度疼痛。癌症相关疼痛会显著增加躯体痛苦,严重损害心理健康和日常生活质量,进一步加重患者的负担。因此本文将以癌性疼痛的外周和中枢机制与缓解治疗方法做一综述,以期为后续癌痛的机制探索和治疗方向提供思路。
Abstract: Cancer pain, defined as persistent or intermittent pain resulting from tumor progression, metastasis, or therapeutic interventions, constitutes a predominant symptom experienced by the majority of cancer patients across all disease stages. As a critical determinant impacting both quality of life and overall survival, it represents one of the most significant challenges in oncology care. Studies indicate that over 66% of patients with advanced cancer experience pain, among whom 55% report moderate to severe intensity. Cancer-related pain markedly exacerbates physical distress, impairs psychological well-being, and substantially compromises daily functioning, thereby imposing additional burdens on affected individuals. This review synthesizes current knowledge on the peripheral and central mechanisms underlying cancer pain and discusses contemporary therapeutic strategies for its alleviation, aiming to provide insights for future mechanistic investigations and treatment innovations.
文章引用:姬甜甜, 高彦东, 边步荣. 关于癌痛机制与治疗方法的研究现状: 一项系统性综述[J]. 临床医学进展, 2026, 16(7): 595-601. https://doi.org/10.12677/acm.2026.1672565

参考文献

[1] Caraceni, A. and Shkodra, M. (2019) Cancer Pain Assessment and Classification. Cancers, 11, Article 510. [Google Scholar] [CrossRef] [PubMed]
[2] Mulvey, M.R., Paley, C.A., Schuberth, A., King, N., Page, A. and Neoh, K. (2024) Neuropathic Pain in Cancer: What Are the Current Guidelines? Current Treatment Options in Oncology, 25, 1193-1202. [Google Scholar] [CrossRef] [PubMed]
[3] Liao, S., Wu, G., Xie, Z., Lei, X., Yang, X., Huang, S., et al. (2024) pH Regulators and Their Inhibitors in Tumor Microenvironment. European Journal of Medicinal Chemistry, 267, Article ID: 116170. [Google Scholar] [CrossRef] [PubMed]
[4] Li, M., Yang, Y., Xiong, L., Jiang, P., Wang, J. and Li, C. (2023) Metabolism, Metabolites, and Macrophages in Cancer. Journal of Hematology & Oncology, 16, Article No. 80. [Google Scholar] [CrossRef] [PubMed]
[5] Zhang, J., Wang, L., Wang, H., Su, Z. and Pang, X. (2019) Neuroinflammation and Central PI3K/Akt/mTOR Signal Pathway Contribute to Bone Cancer Pain. Molecular Pain, 15. [Google Scholar] [CrossRef] [PubMed]
[6] Peng, Y., Wang, Y., Zhou, C., Mei, W. and Zeng, C. (2022) PI3K/Akt/mTOR Pathway and Its Role in Cancer Therapeutics: Are We Making Headway? Frontiers in Oncology, 12, Article 819128. [Google Scholar] [CrossRef] [PubMed]
[7] Hu, T., Pang, M., Sun, Q., Gou, Y., Liu, J., Wang, X., et al. (2025) Sema3A Relieves Neuropathic Pain by Reducing eIF2α Phosphorylation via Suppressing PI3K/Akt/mTOR Pathway. The Journal of Pain, 30, Article ID: 105374. [Google Scholar] [CrossRef] [PubMed]
[8] Zheng, X., Wu, Y., Huang, J. and Wu, A. (2022) Neurophysiological Mechanisms of Cancer-Induced Bone Pain. Journal of Advanced Research, 35, 117-127. [Google Scholar] [CrossRef] [PubMed]
[9] Chinreddy, S.R., Mashozhera, N.T., Rashrash, B., Flores-Iga, G., Nimmakayala, P., Hankins, G.R., et al. (2024) Unraveling TRPV1’s Role in Cancer: Expression, Modulation, and Therapeutic Opportunities with Capsaicin. Molecules, 29, Article 4729. [Google Scholar] [CrossRef] [PubMed]
[10] Iftinca, M., Defaye, M. and Altier, C. (2021) TRPV1-Targeted Drugs in Development for Human Pain Conditions. Drugs, 81, 7-27. [Google Scholar] [CrossRef] [PubMed]
[11] Abd-Elsayed, A., Vardhan, S., Aggarwal, A., Vardhan, M. and Diwan, S.A. (2024) Mechanisms of Action of Dorsal Root Ganglion Stimulation. International Journal of Molecular Sciences, 25, Article 3591. [Google Scholar] [CrossRef] [PubMed]
[12] Esposito, M.F., Malayil, R., Hanes, M. and Deer, T. (2019) Unique Characteristics of the Dorsal Root Ganglion as a Target for Neuromodulation. Pain Medicine, 20, S23-S30. [Google Scholar] [CrossRef] [PubMed]
[13] Fink, W. and Raffa, R. (2025) A Pluripotent Progression of the Gate Control System Theory of Pain—Modeling Ascending & Descending Pain Pathways as a Lotka-Volterra Coupled Control & Feedback Loop. Journal of Pain Research, 18, 4373-4385. [Google Scholar] [CrossRef
[14] Wang, W., Hao, Y., Pang, X. and Tang, Y. (2025) Cancer Pain: Molecular Mechanisms and Management. Molecular Biomedicine, 6, Article No. 45. [Google Scholar] [CrossRef] [PubMed]
[15] Xie, X., Li, Y., Su, S., Li, X., Xu, X., Gao, Y., et al. (2024) Neuroligins Facilitate the Development of Bone Cancer Pain via Regulating Synaptic Transmission: An Experimental Study. Brazilian Journal of Anesthesiology (English Edition), 74, Article ID: 744422. [Google Scholar] [CrossRef] [PubMed]
[16] Liu, H., Lv, X., Zhao, X., Yi, L., Lv, N., Xu, W., et al. (2024) Spinal Astrocyte-Derived Interleukin-17a Promotes Pain Hypersensitivity in Bone Cancer Mice. Acta Pharmaceutica Sinica B, 14, 5249-5266. [Google Scholar] [CrossRef] [PubMed]
[17] Hiraga, S., Itokazu, T., Nishibe, M. and Yamashita, T. (2022) Neuroplasticity Related to Chronic Pain and Its Modulation by Microglia. Inflammation and Regeneration, 42, Article No. 15. [Google Scholar] [CrossRef] [PubMed]
[18] Gilabert, D., Duveau, A., Carracedo, S., Linck, N., Langla, A., Muramatsu, R., et al. (2023) Microglial P2X4 Receptors Are Essential for Spinal Neurons Hyperexcitability and Tactile Allodynia in Male and Female Neuropathic Mice. iScience, 26, Article ID: 108110. [Google Scholar] [CrossRef] [PubMed]
[19] McKenzie, A., Dombrower, R., Theeraphapphong, N., McKenzie, S. and Hijazin, M.A. (2025) Glial Activation, Neuroinflammation, and Loss of Neuroprotection in Chronic Pain: Cellular Mechanisms and Emerging Therapeutic Strategies. Biomedicines, 14, Article 58. [Google Scholar] [CrossRef
[20] Qu, S., Wang, H., Hu, Q., Ma, Y., Kang, Y., Ma, L., et al. (2025) Electroacupuncture May Alleviate Diabetic Neuropathic Pain by Inhibiting the Microglia P2X4R and Neuroinflammation. Purinergic Signalling, 21, 533-547. [Google Scholar] [CrossRef] [PubMed]
[21] Mestdagh, F., Steyaert, A. and Lavand’homme, P. (2023) Cancer Pain Management: A Narrative Review of Current Concepts, Strategies, and Techniques. Current Oncology, 30, 6838-6858. [Google Scholar] [CrossRef] [PubMed]
[22] Paice, J.A., Bohlke, K., Barton, D., Craig, D.S., El-Jawahri, A., Hershman, D.L., et al. (2023) Use of Opioids for Adults with Pain from Cancer or Cancer Treatment: ASCO Guideline. Journal of Clinical Oncology, 41, 914-930. [Google Scholar] [CrossRef] [PubMed]
[23] Jin, H., Liang, J., Zhang, S., Ma, S., Qin, H., Zhang, D., et al. (2024) External Treatment of Traditional Chinese Medicine for Cancer Pain: A Systematic Review and Network Meta-Analysis. Medicine, 103, e37024. [Google Scholar] [CrossRef] [PubMed]
[24] Yang, X., Zhang, R., Wang, A., Zhang, D., Cheng, J., Zhai, B., et al. (2025) Pharmacological Management of Cancer Pain: Advances in Treatment Strategies and Drug Delivery Systems. Pharmaceutics, 18, Article 6. [Google Scholar] [CrossRef
[25] Mannes, A.J., Heiss, J.D., Berger, A., Alewine, C.C., Butman, J.A., Hughes, M.S., et al. (2025) Treatment of Intractable Cancer Pain with Resiniferatoxin—An Interim Study. NEJM Evidence, 4, EVIDoa2400423. [Google Scholar] [CrossRef] [PubMed]
[26] Lor, K., Kubrova, E., D’Souza, R.S., Hoffmann, C., Banks, D., Jin, M.Y., et al. (2025) Interventional Therapies to Treat Cancer Associated Pain. Current Treatment Options in Oncology, 26, 654-671. [Google Scholar] [CrossRef] [PubMed]
[27] (2023) [Chinese Expert Consensus on Patient-Controlled Intravenous Analgesia for Cancer Pain]. Chinese Medical Journal, 103, 793-802. (In Chinese)
[28] Lin, R., Lin, S., Feng, S., Wu, Q., Fu, J., Wang, F., et al. (2021) Comparing Patient-Controlled Analgesia versus Non-PCA Hydromorphone Titration for Severe Cancer Pain: A Randomized Phase III Trial. Journal of the National Comprehensive Cancer Network, 19, 1148-1155. [Google Scholar] [CrossRef] [PubMed]
[29] Ahn, J.S., Lin, J., Ogawa, S., Chen, Y., O’Brien, T., Le, B., et al. (2017) Transdermal Buprenorphine and Fentanyl Patches in Cancer Pain: A Network Systematic Review. Journal of Pain Research, 10, 1963-1972. [Google Scholar] [CrossRef] [PubMed]
[30] Wang, D., Ma, T., Zhu, H. and Peng, C. (2018) Transdermal Fentanyl for Cancer Pain: Trial Sequential Analysis of 3406 Patients from 35 Randomized Controlled Trials. Journal of Cancer Research and Therapeutics, 14, S14-S21. [Google Scholar] [CrossRef] [PubMed]