Edward Chow1,2, Keyue Ding3, Wendy R Parulekar3, Rebecca K S Wong4, Yvette M van der Linden5, Daniel Roos6, William F Hartsell7, Peter Hoskin8, Jackson S Y Wu9, Abdenour Nabid10, Francisca Ong11, Geertjan van Tienhoven12, Scott Babington13, William F Demas14, Carolyn F Wilson3, Michael Brundage15, Liting Zhu3, Ralph M Meyer16. 1. Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada. Edward.Chow@sunnybrook.ca. 2. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. Edward.Chow@sunnybrook.ca. 3. NCIC Clinical Trials Group, Cancer Research Institute, Queen's University, Kingston, ON, Canada. 4. Princess Margaret Cancer Centre, Radiation Medicine Program, Ontario Cancer Institute, University of Toronto, Toronto, ON, Canada. 5. Leiden University Medical Centre, Leiden and Radiotherapy Institute Friesland, Leeuwarden, Netherlands. 6. Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia. 7. Central DuPage Hospital Cancer Center, Warrenville, IL, USA. 8. Mount Vernon Hospital Cancer Centre, Middlesex, UK. 9. Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada. 10. Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada. 11. Medisch Spectrum Twente, Enschede, Netherlands. 12. Academic Medical Center, Amsterdam, Netherlands. 13. Christchurch Hospital, Christchurch, New Zealand. 14. Akron City Hospital, Northeast Ohio Medical University, Akron, OH, USA. 15. Queen's University, Kingston, ON, Canada. 16. Juravinski Hospital and Cancer Centre and McMaster University, Hamilton, ON, Canada.
Abstract
PURPOSE: The objective of our study was to determine the optimal cut points for classification of pain scores as mild, moderate, and severe based on interference with function and quality of life (QOL). METHODS: We evaluated 822 patients who completed the Brief Pain Inventory (BPI) and/or the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 30 (QLQ-C30) prior to receiving repeat radiation therapy for previously irradiated painful bone metastases. Optimal cut points for mild, moderate, and severe pain were determined by the MANOVA that yielded the largest F ratio for the between category effect on the seven interference items of BPI and the six functional domains of QOL (physical, role, emotional, cognitive, social functioning, and global QOL) as indicated by Pillai's Trace, Wilk's λ, and Hostelling's Trace F statistics. RESULTS: For BPI and for QOL domains separately, the two largest F ratios for Wilk's λ, Pillai's Trace, and Hotelling's Trace F statistics were from the cut points 4, 8 and 6, 8. When combining both, the optimal cut points were 4, 8 with 1-4 (mild), 5-8 (moderate), and 9-10 (severe). With this classification, the mean scores of all the seven interference items in BPI and the six functional domains were all highly statistically different. Patients with severe pain survived significantly shorter than those with mild and moderate pain (p < 0.0001). CONCLUSION: Our analysis supports the classification of pain scores as follows: 1-4 as mild pain, 5-8 as moderate pain, and 9-10 as severe pain. This may facilitate conduct of future clinical trials.
PURPOSE: The objective of our study was to determine the optimal cut points for classification of pain scores as mild, moderate, and severe based on interference with function and quality of life (QOL). METHODS: We evaluated 822 patients who completed the Brief Pain Inventory (BPI) and/or the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 30 (QLQ-C30) prior to receiving repeat radiation therapy for previously irradiated painful bone metastases. Optimal cut points for mild, moderate, and severe pain were determined by the MANOVA that yielded the largest F ratio for the between category effect on the seven interference items of BPI and the six functional domains of QOL (physical, role, emotional, cognitive, social functioning, and global QOL) as indicated by Pillai's Trace, Wilk's λ, and Hostelling's Trace F statistics. RESULTS: For BPI and for QOL domains separately, the two largest F ratios for Wilk's λ, Pillai's Trace, and Hotelling's Trace F statistics were from the cut points 4, 8 and 6, 8. When combining both, the optimal cut points were 4, 8 with 1-4 (mild), 5-8 (moderate), and 9-10 (severe). With this classification, the mean scores of all the seven interference items in BPI and the six functional domains were all highly statistically different. Patients with severe pain survived significantly shorter than those with mild and moderate pain (p < 0.0001). CONCLUSION: Our analysis supports the classification of pain scores as follows: 1-4 as mild pain, 5-8 as moderate pain, and 9-10 as severe pain. This may facilitate conduct of future clinical trials.
Entities:
Keywords:
Bone metastases; Functional interference; Pain severity; Quality of life; Re-irradiation; Survival
Authors: Edward Chow; Ralph M Meyer; Bingshu E Chen; Yvette M van der Linden; Daniel Roos; William F Hartsell; Peter Hoskin; Jackson S Y Wu; Abdenour Nabid; Caroline J A Tissing-Tan; Bing Oei; Scott Babington; William F Demas; Carolyn F Wilson; Rebecca K S Wong; Michael Brundage Journal: J Clin Oncol Date: 2014-10-27 Impact factor: 44.544
Authors: N K Aaronson; S Ahmedzai; B Bergman; M Bullinger; A Cull; N J Duez; A Filiberti; H Flechtner; S B Fleishman; J C de Haes Journal: J Natl Cancer Inst Date: 1993-03-03 Impact factor: 13.506
Authors: Francesca Luzzati; Emanuele Maria Giusti; Gennaro Maria Scotto; Giuseppe Perrucchini; Luca Cannavò; Gianluca Castelnuovo; Andrea Colonna Cottini Journal: Support Care Cancer Date: 2019-07-01 Impact factor: 3.603
Authors: Rachel McDonald; Keyue Ding; Edward Chow; Ralph M Meyer; Abdenour Nabid; Pierre Chabot; Genevieve Coulombe; Shahida Ahmed; Joda Kuk; Rashid Dar; Aamer Mahmud; Alysa Fairchild; Carolyn F Wilson; Jackson S Y Wu; Kristopher Dennis; Carlo DeAngelis; Rebecca K S Wong; Liting Zhu; Michael Brundage Journal: Support Care Cancer Date: 2016-07-27 Impact factor: 3.603