ESTRO 2025 - Abstract Book

S1578

Clinical – Mixed sites & palliation

ESTRO 2025

4161

Digital Poster Capsaicin Patch Therapy for Chronic Neuropathic Pain in Breast Cancer Survivors: Importance of Early Diagnosis and Intervention Javier Anchuelo 1 , Ana L Rivero 2 , Paola Navarrete 2 , Piedad Galdós 2 , Ana S García 2 , Isela Morán 2 , Ana Aliaga 1 , Arantxa Campos 1 , Irene Carruesco 1 , Reyes Ibáñez 1 , Martín Tejedor 1 , Arantxa Ayete 1 , Jesús Mazaira 3 , María Díaz de Tuesta 4 , Frandeína Pinto 5 , Mara García 2 , Germán Valtueña 1 , Jaime Jimeno 6 , Carmen Hinojo 7 , Aurora Carrasquer 8 , Pedro J Prada 2 1 Radiation Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain. 2 Radiation Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 3 Gyanecology, Hospital General de Sierrallana, Torrelavega, Spain. 4 Radiology, Hospital General de Sierrallana, Torrelavega, Spain. 5 Radiation Oncology, Hospital Unversitario Marqués de Valdecilla, Santander, Spain. 6 Breast Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 7 Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 8 General Surgery, Hospital de Barbastro, Barbastro, Spain Purpose/Objective: Chronic neuropathic pain (CNP) significantly impairs the quality of life in breast cancer survivors, affecting up to 60% of patients post-surgery. Risk factors include acute postoperative pain, radiotherapy, and surgical complications. This study evaluates the effectiveness of capsaicin patch therapy in reducing CNP and emphasizes the importance of early intervention. Material/Methods: From August 2020 to February 2024, 72 capsaicin patch applications were performed on breast cancer patients with CNP at a single institution. Patients were assessed using DN4 and LANSS questionnaires and visual analog scale (VAS) scores pre- and post-treatment. One-third of patients had postoperative complications (hematoma, seroma, or infection). Results: Among patients requiring only one application (65%), the median baseline VAS was 7.5, decreasing to 1.5 post treatment (average pain reduction: 5.2 points). The mean time from the last patch application to the most recent follow-up in this group was 17.5 months (range: 2 – 44 months). For patients requiring two applications (28.5%), the median baseline VAS was 8, decreasing to 2.1 post-treatment. The mean time from pain onset to the first patch application was 15.5 months (median: 2.5 months). In these patients, the mean time between pain onset and the first patch application was 26 months (median: 27.5 months), and the mean interval between the first and second application was 11 months (median: 11 months). The mean time from the last patch application to the most recent follow-up in this group was also 17.5 months (range: 2 – 44 months). The discrepancy between mean and median times highlights the importance of early diagnosis and treatment to prevent chronicity, consistent with literature on chronic pain management. Current guidelines recommend three applications for optimal results; however, our data indicate substantial benefit even after one or two applications. Pain resolution (VAS 0-2) was achieved in 59% of patients after one application, with further improvements in multi-application cases. Adverse effects were mild and self-limiting, with 81% of patients reporting improvement by the next day. Conclusion: Capsaicin patch therapy demonstrates safety and efficacy in managing CNP, particularly when administered early. Administering the treatment prior to the initiation of radiotherapy in patients with neuropathic pain could potentially prevent chronicity and optimize outcomes. Early and accurate diagnosis is essential to align treatment with emerging guidelines for chronic pain management in breast cancer survivors. Further studies should explore the timing of intervention and its long-term benefits.

Keywords: Capsaicin patch, neuropatic pain, breast cancer