Abstract：
The epidemiology and prognosis of radiation-induced chronic pain, especially chronic neuropathic pain (CNP), are the understudied domain among head and neck cancer (HNC) survivors after radiotherapy (RT). This study aimed to estimate the prevalence of such chronic pain, and explore their correlations with mental health, sleep disorders, cognitive function, and quality of life (QOL) within these patients. This research encompassed HNC survivors post-RT. The determination of radiation-induced chronic pain and CNP adhered to the guidelines outlined by the International Association for the Study of Pain (IASP). Multivariable regression analyses were employed to explore the relationship between pain and anxiety, depression, sleep disturbances, cognitive function, and QOL. A total of 1071 HNC survivors post-RT were included in this study. The prevalence of radiation-induced chronic pain was 67.1%, and the prevalence of RT-associated CNP was 38.3%,. Compared with those reporting no pain, patients with radiation-induced chronic pain had a significantly increased risk of anxiety, depression and sleep disorders (all p < 0.001). And there was a significantly negative association between chronic pain and QOL across physiological (p < 0.001), psychological (p < 0.001), social relationships (p = 0.001) and environmental (p = 0.009) domains. Compared with non-CNP, patients with RT-related CNP had a higher risk of anxiety (p= 0.027) and sleep disorders (p= 0.013). The significantly negative associations were found between CNP and the physiological (p = 0.001), psychological (p = 0.012) and social score (p = 0.035) in WHOQOL-BREF. This study underscores the substantial prevalence of chronic pain, particularly CNP, and their potential impact on the mental health, sleep, and QOL among HNC survivors post-RT. PERSPECTIVE: This study highlights the high prevalence of radiation-induced chronic pain and CNP, and their potential impacts on anxiety, depression, sleep and QOL among the HNC survivors. Clinically, these findings have important implications for improving the care and outcomes of HNC survivors.
摘要：
放射性慢性疼痛的流行病学和预后,尤其是慢性神经性疼痛（CNP），是头颈癌（HNC）幸存者放疗（RT）后的研究不足的领域。这项研究旨在估计这种慢性疼痛的患病率，探索他们与心理健康的关系，睡眠障碍,认知功能,以及这些患者的生活质量（QOL）。这项研究包括RT后的HNC幸存者。辐射引起的慢性疼痛和CNP的测定符合国际疼痛研究协会（IASP）概述的指南。采用多元回归分析探讨疼痛与焦虑之间的关系，抑郁症,睡眠障碍,认知功能,和QOL。共有1071名RT后HNC幸存者被纳入本研究。放射性慢性疼痛的患病率为67.1%,与RT相关的CNP的患病率为38.3％，.与那些报告没有疼痛的人相比，放射性慢性疼痛患者焦虑风险显著增加,抑郁症和睡眠障碍（所有p<0.001）。慢性疼痛和生活质量之间存在显著的负相关（p<0.001），心理(p<0.001)，社会关系(p=0.001)和环境(p=0.009)领域。与非CNP相比,RT相关CNP患者出现焦虑(p=0.027)和睡眠障碍(p=0.013)的风险较高.在CNP和生理之间发现了显著的负相关(p=0.001)，WHOQOL-BREF的心理评分(p=0.012)和社会评分(p=0.035)。这项研究强调了慢性疼痛的大量流行，特别是CNP，以及它们对心理健康的潜在影响，睡眠,RT后HNC幸存者的生活质量。观点：这项研究强调了辐射引起的慢性疼痛和CNP的高患病率，以及它们对焦虑的潜在影响，抑郁症,HNC幸存者的睡眠和生活质量。临床上,这些发现对于改善HNC幸存者的护理和结局具有重要意义.
