癌症后的疼痛仍然被低估和未能得到充分治疗。精准医学是一个新的概念，它指的是将患者分类为不同的亚组，这些亚组在特定疾病的易感性、生物学或预后，或对特定治疗的响应方面存在差异，因此可以根据个体患者特征量身定制治疗。将这一概念应用于癌症后的疼痛，将癌后疼痛分类为三种主要疼痛表型（即伤害性、神经性和非海洛因性疼痛），并相应调整疼痛治疗，是一个新兴的问题。这尤其重要，因为现有证据表明，非海洛因性疼痛在经历癌症后疼痛的一部分患者中存在。2021年国际疼痛学会（IASP）针对非海洛因性疼痛的临床标准和分级系统，考虑到了早期鉴定和正确分类疼痛表型的需求。这些标准是精准疼痛医学的一个重要步骤，对临床肿瘤学领域具有巨大潜力。在这一框架下，癌症疼痛表型（CANPPHE）网络是一个国际跨学科肿瘤临床医生和研究人员组成的团队，来自七个国家，应用2021年IASP非海洛因性疼痛的临床标准，面向越来越多经历癌症后疼痛的患者群体。提供了一个手册，以帮助临床医生区分在癌症后占主导的伤害性、神经性或非海洛因性疼痛。介绍了一个七步诊断方法，并使用案例进行解释，以增强理解并鼓励在临床实践中有效实施这一方法。版权所有© 2022作者。由爱思维尔出版社出版。保留所有权利。

Pain after cancer remains underestimated and undertreated. Precision medicine is a recent concept that refers to the ability to classify patients into subgroups that differ in their susceptibility to, biology, or prognosis of a particular disease, or in their response to a specific treatment, and thus to tailor treatment to the individual patient characteristics. Applying this to pain after cancer, the ability to classify post-cancer pain into the three major pain phenotypes (i.e. nociceptive, neuropathic, and nociplastic pain) and tailor pain treatment accordingly, is an emerging issue. This is especially relevant because available evidence suggests that nociplastic pain is present in an important subgroup of those patients experiencing post-cancer pain. The 2021 International Association for the Study of Pain (IASP) clinical criteria and grading system for nociplastic pain account for the need to identify and correctly classify patients according to the pain phenotype early in their treatment. These criteria are an important step towards precision pain medicine with great potential for the field of clinical oncology. Within this framework, the Cancer Pain Phenotyping (CANPPHE) Network, an international and interdisciplinary group of oncology clinicians and researchers from seven countries, applied the 2021 IASP clinical criteria for nociplastic pain to the growing population of those experiencing post-cancer pain. A manual is provided to allow clinicians to differentiate between predominant nociceptive, neuropathic, or nociplastic pain after cancer. A seven-step diagnostic approach is presented and illustrated using cases to enhance understanding and encourage effective implementation of this approach in clinical practice.Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.