Manuel Dómine Gómez1, Nieves Díaz Fernández2, Blanca Cantos Sánchez de Ibargüen3, Luis Zugazabeitia Olabarría4, Joaquina Martínez Lozano5, Raúl Poza de Celis6, Rafael Trujillo Vílchez7, Ignacio Peláez Fernández8, Jaume Capdevila Castillón9, Susana Traseira Lugilde10, Emilio Esteban González11. 1. Medical Oncology Department, Fundación Jiménez Díaz, Madrid, Spain. mdomine@fjd.es. 2. Medical Oncology Department, Hospital San Juan de Alicante, Alicante, Spain. 3. Medical Oncology Department, Hospital Puerta de Hierro de Majadahonda, Madrid, Spain. 4. Radiation Oncology Department, Hospital de Povisa, Vigo, Pontevedra, Spain. 5. Medical Oncology Department, Clínica Nuestra Señora de Belén, Murcia, Spain. 6. Radiation Oncology Department, Hospital Txagorritxu, Vitoria-Gasteiz, Álava, Spain. 7. Medical Oncology Department, Vithas Xanit Hospital Internacional, Málaga, Spain. 8. Medical Oncology Department, Hospital de Cabueñes, Gijón, Asturias, Spain. 9. Medical Oncology Department, Hospital Vall d'Hebron, Barcelona, Spain. 10. Medical Department, Mundipharma Pharmaceuticals S.L., Madrid, Spain. 11. Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Abstract
INTRODUCTION: Bone metastasis is the most common cause of cancer-related pain, and metastatic bone pain (MBP) is not only severe but also progressive in many patients. The aim of this study was to investigate the association between pain management and performance status in patients with metastatic bone cancer in the Spanish clinical setting. METHODS: A 3-month follow-up prospective, epidemiologic, multicenter study was conducted in 579 patients to assess the evolution of their performance, the impact of pain control on sleep and functionality, and the degree of pain control according to analgesic treatment. RESULTS: In patients with MBP, Eastern Cooperative Oncology Group (ECOG) status (1.5 ± 0.7-1.3 ± 0.7 and 1.3 ± 0.8; p < 0.001) and pain (6.5 ± 1.4-2.8 ± 1.9 and 2.1 ± 1.9; p < 0.001) improved significantly from baseline to months 1 and 3, as did functionality and sleep, after a treatment change consisting of increasing the administration of opioids. Evolution of ECOG and pain were closely related. ECOG and pain outcomes were significantly more favorable in patients treated with opioids versus non-opioid treatment, and in patients who did not need rescue medication versus those who did. CONCLUSIONS: MBP is currently poorly managed in Spain. ECOG improvement is closely and directly related to pain management in MBP. Opioid treatment and a lack of requirements for rescue medication are associated with better ECOG and pain outcomes in MBP patients. FUNDING: Mundipharma Pharmaceuticals S.L.
INTRODUCTION: Bone metastasis is the most common cause of cancer-related pain, and metastatic bone pain (MBP) is not only severe but also progressive in many patients. The aim of this study was to investigate the association between pain management and performance status in patients with metastatic bone cancer in the Spanish clinical setting. METHODS: A 3-month follow-up prospective, epidemiologic, multicenter study was conducted in 579 patients to assess the evolution of their performance, the impact of pain control on sleep and functionality, and the degree of pain control according to analgesic treatment. RESULTS: In patients with MBP, Eastern Cooperative Oncology Group (ECOG) status (1.5 ± 0.7-1.3 ± 0.7 and 1.3 ± 0.8; p < 0.001) and pain (6.5 ± 1.4-2.8 ± 1.9 and 2.1 ± 1.9; p < 0.001) improved significantly from baseline to months 1 and 3, as did functionality and sleep, after a treatment change consisting of increasing the administration of opioids. Evolution of ECOG and pain were closely related. ECOG and pain outcomes were significantly more favorable in patients treated with opioids versus non-opioid treatment, and in patients who did not need rescue medication versus those who did. CONCLUSIONS:MBP is currently poorly managed in Spain. ECOG improvement is closely and directly related to pain management in MBP. Opioid treatment and a lack of requirements for rescue medication are associated with better ECOG and pain outcomes in MBPpatients. FUNDING: Mundipharma Pharmaceuticals S.L.
Authors: C Jara; S Del Barco; C Grávalos; S Hoyos; B Hernández; M Muñoz; T Quintanar; J A Meana; C Rodriguez; R de Las Peñas Journal: Clin Transl Oncol Date: 2017-11-10 Impact factor: 3.405