Palliative Radiation Treatment in Patients Managed With Advanced/Interventional Pain Therapy such as Pump-delivered Continuous Opioids.

IF 1.6 4区 医学 Q4 ONCOLOGY Anticancer research Pub Date : 2024-10-01 DOI:10.21873/anticanres.17271
Carsten Nieder, Stine M Jensen, Solveig Nilsen, Ellinor C Haukland
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Abstract

Background/aim: The study aim was to analyze the feasibility and efficacy of palliative radiotherapy in patients receiving advanced/interventional pain therapy, such as epidural or spinal anesthesia or subcutaneous pump delivery of opioids. Endpoints such as pain relief, treatment in the last month of life and survival were evaluated.

Patients and methods: Different baseline parameters including but not limited to age and Eastern Cooperative Oncology Group performance status (ECOG PS) were assessed. Outcomes were abstracted from electronic health records. The Edmonton Symptom Assessment System (ESAS) was utilized to score pain intensity.

Results: The study included 48 patients, 44 of whom completed radiotherapy as prescribed. Device malfunction was not observed. Overall, 31 patients (65%) had journal notes available allowing for evaluation of pain relief. Twenty-six of 31 experienced pain relief (54% in the intention-to-treat population of 48 study patients). Twelve patients (25%) stopped interventional pain therapy and were converted to transdermal or oral drugs. Median survival was 1.6 months. Forty-four percent had received radiotherapy during the last month of life. Sixty-four percent of patients with ECOG PS 3-4 had received radiotherapy during the last month of life, compared to 22% of those with ECOG PS <3, p=0.004.

Conclusion: Palliative radiotherapy was feasible in this setting, but given the short median survival and high likelihood of treatment during the last month of life, patient selection and choice of fractionation regimen should be optimized. The record review identified several patients who experienced worthwhile pain relief, sometimes leading to conversion of pain therapy back to non-invasive oral or transdermal application.

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采用先进的/介入性疼痛疗法(如泵给式连续阿片类药物)对患者进行姑息性放射治疗。
背景/目的:该研究旨在分析姑息放疗在接受晚期/介入性疼痛治疗(如硬膜外或脊髓麻醉或阿片类药物皮下泵给药)患者中的可行性和有效性。患者和方法:评估了不同的基线参数,包括但不限于年龄和东部合作肿瘤学组(Eastern Cooperative Oncology Group)表现状态(ECOG PS)。结果摘自电子健康记录。采用埃德蒙顿症状评估系统(ESAS)对疼痛强度进行评分:研究共纳入 48 名患者,其中 44 人按照医嘱完成了放疗。未发现设备故障。总体而言,31 名患者(65%)有日志记录,可以对疼痛缓解情况进行评估。31名患者中有26名疼痛缓解(在48名研究患者的意向治疗人群中占54%)。12名患者(25%)停止了介入止痛治疗,转为使用透皮或口服药物。中位生存期为 1.6 个月。44%的患者在生命的最后一个月接受了放疗。64%的ECOG PS 3-4患者在生命的最后一个月接受了放疗,而ECOG PS结论为3-4的患者只有22%接受了放疗:姑息放疗在这种情况下是可行的,但考虑到中位生存期较短以及在生命最后一个月接受治疗的可能性较高,应优化患者选择和分次治疗方案的选择。记录审查发现,有几名患者的疼痛得到了有效缓解,有时导致疼痛治疗转回非侵入性口服或透皮应用。
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来源期刊
Anticancer research
Anticancer research 医学-肿瘤学
CiteScore
3.70
自引率
10.00%
发文量
566
审稿时长
2 months
期刊介绍: ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.
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