Učestalost i osobitosti boli djece sa solidnim malignim tumorima Incidence and characteristics of pain in children with solid malignant tumors

摘要

In this retrospective study data of 386 children with solid malignant tumors treated in Children's Hospital Zagreb during ten years period (1999.-2008) were collected. Data od age and gender of children, tumor type and stage at time of diagnosis, and pain characteristics as intensity, type and duration were analysed. Tumors were divided by their localisation to abdominal, musculo-skeletal and tumors of central nervous system. Tumor stages were lokalised, operable tumor, infiltrating, inoperable and disseminated tumor. Incidence of pain, pain characteristics (somatic, visceral, neuropatic, mixed somatic and neuropathic and mixed somatic and visceral pain), pain intensity and duration were compared with types and stages of solid malignant tumors. Results from two five years intervals were compared (1999.-2003. and 2004.-08) as possible indicator of improvement in the quality of pediatric health care. Incidence of pain in children with solid malignant tumors was 71,5%. Incidence of pain in abdominal tumors was 64,6%, in musculo-skeletal 83,5% and in central nervous system tumors 67%. Incidence of somatic pain was 47,2%, of visceral pain 12,2%, of neuropathic pain 5,2%, mixed somatic-neuropathic pain 4,4% and incidence of mixed somatic-visceral pain was 2,6 %. Comparison of pain intensity, duration and pain type and type of solid malignant tumor showed positive correlation between duration of pain, pain type and type of tumor. Comparison of pain intensity, duration and pain type and tumor stage positive correlation was found between intensity and pain type and stage of tumor. Comparing two five years periods statistically significant difference was found in pain intensity and extensity of tumors. Conclusion is that in the second period the quality of health care of children with SMT was better because diagnosis has been made when intensity of pain was lower and tumors in less extensive stage. This study is the beginning of further studies of incidence and prevalence of pain in children with solid malignant tumors and foundation of guidelines for early recognition of SMT with emphasis on intensity, duration and characteristics of pain.