[Medical treatment including pregabalin and radiation therapy provided remarkable relief for neuropathic pain by brachial plexus invasion in a patient with esophageal cancer]

Abstract

This paper presents the case of a man in his 60's with advanced esophageal cancer after the first course of 5-FU/CDDP therapy during follow-up visit, who had pain and numbness from right scapula to upper arm. MRI revealed bone metastasis in the first thoracic vertebra and lymph node metastasis to be diagnosed as neuropathic pain by brachial plexus invasion. Radiation therapy and medical treatment with lornoxicam and controlled-release oxycodone started. However, breakthrough pain in the night was remarkably severe and numerical rating scale was 9-10/10. Pregabalin as analgesic adjuvant was administrated from dose of 75mg/day to 300mg/day and the breakthrough pain in the night disappeared completely. The patient underwent the second course of 5-FU/CDDP therapy without the pain. In the present case, the combined therapy of medical treatment and radiation therapy provided complete relief of the neuropathic pain. We conclude that it is an option to select pregabalin as effective agent for neuropathic pain in medical treatment.