• Hai-Li Li, Gege Gong, Jiang-Lin Wang, and Fu-Bo Li.
• Department of Pain Management, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China; Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, Sichuan Province, P.R. China.
• Pain Physician. 2023 Jul 1; 26 (4): E397E403E397-E403.

BackgroundThe high risk of developing postherpetic neuralgia (PHN) is associated with severe immunosuppressive diseases. A malignancy itself, as well as surgery, radiotherapy, and other treatments, can lead to changes in the immune status of the body and predispose patients with a malignancy to PHN.ObjectiveTo investigate the risk factors of postherpetic neuralgia in herpes zoster (HZ) after a malignant tumor and to provide better preventive strategies for clinical practice.Study DesignA retrospective cohort study.SettingThe Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China.MethodsPatients who developed HZ after being diagnosed with a malignant tumor in the Affiliated Hospital of Southwest Medical University from September 2018 through March 2022 were included in the research. A total of 70 patients were included, including 31 men and 39 women, aged 18- 82 years old (mean, SD: 59.77 ± 13.95). According to the occurrence of PHN, they were divided into a non-PHN (n = 46) and a PHN group (n = 24). General information about the patients was collected, including clinical data, treatment status, and prognosis. Univariate and multivariate analyses were conducted of influencing factors.ResultsA total of 19 factors, including gender, age, and white blood cell count, were included. A univariate analysis showed that there were differences in age, tumor stage, Numeric Rating Scale (NRS-11) score, and the use of antiviral drugs between the 2 groups; these differences were statistically significant, P <0.05. A multifactorial analysis revealed that the acute phase NRS-11 score (odds ratio [OR] = 4.21; 95% CI, 1.59-2.24, P = 0.004), antiviral drug use (OR = 0.28; 95% CI, 0.10-0.82, P = 0.020), and tumor stage (OR = 0.28, 95% CI, 0.08-0.98, P = 0.047) were statistically significant for the effect of PHN occurring in postmalignancy HZ. There was a statistically significant difference between the group with severe pain in the acute phase NRS-11 score and the group with mild and moderate pain, P < 0.05. There was a statistically significant difference between the group treated with 2 antivirals and the group not treated with antivirals, P < 0.05.LimitationsThere are some limitations in our research. It was conducted at a single center, with a single race, and had a small sample size. A larger-scale study should be conducted to analyze the influencing factors of PHN in patients with herpes zoster after a malignant tumor.ConclusionsThe NRS-11 score in the acute phase, whether the use of antiviral drugs in sufficient quantities, and tumor staging are the influencing factors of PHN after malignant tumors.

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