Pain after Palliative Radiotherapy for Spine Metastases

详细信息    查看全文

• 作者：O. Zaikova ; S.D. Fosså ; U. Kongsgaard ; S. Kvalø ; y ; K.-E. Giercksky ; S. Skjeldal
• 关键词：Pain ; radiotherapy ; response criteria ; response rates ; spine metastases
• 刊名：Clinical Oncology
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：22
• 期：10
• 页码：828-836
• 全文大小：171 K

文摘

Aims

The purpose of the study was to evaluate the response to palliative radiotherapy in patients with painful spinal metastatic disease (SMD).

Materials and methods

Three hundred and fifty-five patients admitted to the Norwegian Radium Hospital for radiotherapy for painful SMD were included in a prospective study and were followed up 2 months later. The Brief Pain Inventory was used to assess pain. Analgesic consumption was recalculated into the daily oral morphine-equivalent dose. The radiotherapy-related response rates were calculated using the criteria of the International Bone Metastases Consensus Group (IBMCG), taking into account the use of concomitant analgesics. The response to radiotherapy was assessed as complete or partial and non-response as stable pain, pain progression or ‘other’.

Results

Brief Pain Inventory forms were obtained at follow-up from 229 of the 355 patients. Two months after radiotherapy, the median self-reported worst pain decreased significantly, but the median oral morphine-equivalent dose increased from 40 to 60 mg (P < 0.001). Forty-three per cent of the patients reported pain relief, but a radiotherapy-related response was found in 37 % of the patients. Overall correspondence between the patients' self-reported changes in pain experience and the IBMCG-based response categories was obtained in 63 % of the patients.

Conclusions

The radiotherapy-related response rates in our study were lower than those reported previously in patients with bone metastases in general, which possibly indicates the presence of more complex pathophysiological mechanisms of pain in SMD.