{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:07:22Z","timestamp":1784012842050,"version":"3.55.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The long-term effects of cancer treatment are increasingly driving persistent pain in cancer survivors; however, the contribution and clinical profile of cancer treatment\u2013related pain (CTRP) in refractory pain populations remain poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of consecutive patients (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009622) referred to a tertiary multidisciplinary cancer pain clinic for initial evaluation of refractory pain (January 2021-June 2025). Pain etiology was classified using ICD-11 criteria as treatment-related pain (TRP; MG30.11), tumor-related pain (MG30.10), or non\u2013cancer-related pain. The multivariate logistic regression analysis identified factors associated with TRP attribution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TRP was identified in 42.1% of patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009262). Patients with TRP were younger than those with tumor-related pain (mean 58.1\u2009\u00b1\u200914.8 vs 64.2\u2009\u00b1\u200912.8\u00a0years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Peripheral neuropathy was strongly associated with TRP attribution (adjusted odds ratio 9.18; 95% CI 2.56\u201332.83). Neuropathic (46.2%) and mixed (35.9%) mechanisms predominated in TRP, whereas nociceptive mechanisms were more common in tumor-related pain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Treatment-related pain constitutes a major component of refractory cancer pain and demonstrates a distinct clinical and mechanistic profiles. Its predominance among younger survivors supports its characterization as a survivorship-associated morbidity rather than an end-of-life phenomenon. These findings support the earlier recognition and integration of mechanism-informed, multidisciplinary supportive care strategies to improve outcomes in patients with persistent treatment-related pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-10886-6","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T02:10:55Z","timestamp":1781230255000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment-related pain in refractory cancer pain: prevalence, mechanisms, and clinical implications in a tertiary referral cohort"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3259-1599","authenticated-orcid":false,"given":"Rotem","family":"Agur","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barak","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulham","family":"Sabbah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silviu","family":"Brill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maor","family":"Staierman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorin","family":"Goldsmith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morsi","family":"Khashan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uri","family":"Hochberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"issue":"3","key":"10886_CR1","doi-asserted-by":"publisher","first-page":"e317","DOI":"10.1016\/j.jpainsymman.2021.09.011","volume":"63","author":"M Evenepoel","year":"2022","unstructured":"Evenepoel M, Haenen V, De Baerdemaecker T, Meeus M, Devoogdt N, Dams L et al (2022) Pain prevalence during cancer treatment: a systematic review and meta-analysis. 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Cancers (Basel) 15(3):591","journal-title":"Cancers (Basel)"},{"issue":"8","key":"10886_CR4","doi-asserted-by":"publisher","first-page":"1420","DOI":"10.1093\/annonc\/mdp001","volume":"20","author":"H Breivik","year":"2009","unstructured":"Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ et al (2009) Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol 20(8):1420\u20131433","journal-title":"Ann Oncol"},{"issue":"1","key":"10886_CR5","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1097\/j.pain.0000000000001363","volume":"160","author":"MI Bennett","year":"2019","unstructured":"Bennett MI, Kaasa S, Barke A, Korwisi B, Rief W, Treede RD et al (2019) The IASP classification of chronic pain for ICD-11: chronic cancer-related pain. Pain 160(1):38\u201344","journal-title":"Pain"},{"issue":"1","key":"10886_CR6","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/j.pain.0000000000001384","volume":"160","author":"RD Treede","year":"2019","unstructured":"Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R et al (2019) Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 160(1):19\u201327","journal-title":"Pain"},{"issue":"6","key":"10886_CR7","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1080\/03007995.2018.1552042","volume":"35","author":"R Freynhagen","year":"2019","unstructured":"Freynhagen R, Parada HA, Calderon-Ospina CA, Chen J, RakhmawatiEmril D, Fern\u00e1ndez-Villacorta FJ et al (2019) Current understanding of the mixed pain concept: a brief narrative review. 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Approval was granted by the Institutional Review Board (Ethics Committee) of the Tel Aviv Sourasky Medical Center (No. 0414\u201325-TLV).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"As this was a retrospective study involving de-identified data, the Institutional Review Board (Ethics Committee) of the Tel Aviv Sourasky Medical Center granted a waiver of informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"647"}}