Adjuvant Therapies As Agent of Pain

After surgical resection of a mass lesion, adjuvant chemotherapy and/or ionizing radiotherapy are often necessary.

These additional treatments do not systematically cause pain in neuro-oncology patients, but have been known to do so in a small percentage of cases.

Chemotherapeutic agents can also cause temporary headaches in neuro-oncology patients for example temozolamide

Unfortunately, the underlying neurobiology of chemotherapy-induced headache pain is still poorly understood.

According to the appendix of the ICHD, headache due to radiosurgery is a new headache developing in cases where radiosurgery of the brain has been performed, the headache arises within 7 days of the surgery and resolves within 3 months, and the headache is not better accounted for by another diagnosis in the third edition of the ICHD.

Conclusion

• It is important to point out that despite the absence of pain receptors

in brain parenchyma, neurosurgery and adjuvant chemoradiation

therapy can be a source of pain and discomfort for patients. A careful

clinical workup and a thorough examination of the patient remain, to

date, the most valuable way to establish the etiological significance of

headache pain and the necessity for physicians to conduct additional

tests. This is often overlooked in our desire to treat the underlying

malignancy, but deserves our full attention if we are to help patients

maintain a better quality of life for as long as possible.