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Prevalence and characterization of breakthrough pain in cancer patients with proctalgia treated with 3D pelvic radiotherapy.

Abstract

PURPOSE

Radiotherapy-induced dysfunction of the gastrointestinal tract is common in cancer patients and has a significant impact on their quality of life. In this study, we investigated the prevalence of breakthrough cancer pain (BTcP) in patients undergoing 3D pelvic radiotherapy and who had proctalgia.

METHODS

This observational, multicenter, cross-sectional epidemiological study was performed in 13 Spanish hospitals. Data were obtained on the presence and characteristics of BTcP, demographics, common comorbidities, and treatments prescribed to the patients.

RESULTS

The prevalence of BTcP in patients undergoing pelvic 3D external radiotherapy with proctalgia (N = 105) was 48.6% (95% CI 39.0-58.1%). BTcP was further characterized in 59 patients. The mean (± SD) intensity of the BTcP episodes was 7.45 ± 1.47 in a visual analog scale. We found several statistically significant associations between the descriptive variables of BTcP with demographic and clinical variables associated with the tumor or the patient, such as an increased number of BTcP episodes per day depending on the presence or absence of diabetes (p = 0.001, Chi-square) or time to the onset of pain relief depending on the location of the tumor (p = 0.019, Chi-square). Fentanyl was the drug of choice in BTcP episodes for 95% of the patients.

CONCLUSIONS

This study demonstrated a high prevalence of BTcP prevalence in cancer patients undergoing pelvic 3D radiotherapy and with proctalgia. Although the variables determining the onset of BTcP are still unclear, our results could help in the design of future clinical studies addressing the treatment of BTcP in these patients.

Authors+Show Affiliations

Department of Radiation Oncology, Hospital Universitary de Sant Joan D'Alacant, Carretera Nacional 332 Alicante-Valencia s/n, Sant Joan D'Alacant, 03550, Alicante, Spain. doctor.vicente.tormo@gmail.com.Department of Radiation Oncology, Hospital Universitary de Sant Joan D'Alacant, Carretera Nacional 332 Alicante-Valencia s/n, Sant Joan D'Alacant, 03550, Alicante, Spain.Department of Radiation Oncology, Hospital Universitari Son Espases, Palma de Mallorca, Spain.Department of Radiation Oncology, Hospital Universitario de Araba, Vitoria, Spain.Department of Radiotherapy, Hospital Clínico Universitario de Valencia, Valencia, Spain.Department of Radiation Oncology, Hospital Clínico San Carlos, Madrid, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30949931

Citation

Ferrero, V T., et al. "Prevalence and Characterization of Breakthrough Pain in Cancer Patients With Proctalgia Treated With 3D Pelvic Radiotherapy." Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2019.
Ferrero VT, Oset MM, Masferrer JP, et al. Prevalence and characterization of breakthrough pain in cancer patients with proctalgia treated with 3D pelvic radiotherapy. Clin Transl Oncol. 2019.
Ferrero, V. T., Oset, M. M., Masferrer, J. P., Pardo, E. H., Sorolla, E. J., & Largo, S. C. (2019). Prevalence and characterization of breakthrough pain in cancer patients with proctalgia treated with 3D pelvic radiotherapy. Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, doi:10.1007/s12094-019-02102-1.
Ferrero VT, et al. Prevalence and Characterization of Breakthrough Pain in Cancer Patients With Proctalgia Treated With 3D Pelvic Radiotherapy. Clin Transl Oncol. 2019 Apr 5; PubMed PMID: 30949931.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and characterization of breakthrough pain in cancer patients with proctalgia treated with 3D pelvic radiotherapy. AU - Ferrero,V T, AU - Oset,M M, AU - Masferrer,J P, AU - Pardo,E H, AU - Sorolla,E J, AU - Largo,S C, AU - ,, Y1 - 2019/04/05/ PY - 2019/02/26/received PY - 2019/03/22/accepted PY - 2019/4/6/entrez KW - Breakthrough pain KW - Pelvic 3D radiotherapy KW - Proctalgia JF - Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico JO - Clin Transl Oncol N2 - PURPOSE: Radiotherapy-induced dysfunction of the gastrointestinal tract is common in cancer patients and has a significant impact on their quality of life. In this study, we investigated the prevalence of breakthrough cancer pain (BTcP) in patients undergoing 3D pelvic radiotherapy and who had proctalgia. METHODS: This observational, multicenter, cross-sectional epidemiological study was performed in 13 Spanish hospitals. Data were obtained on the presence and characteristics of BTcP, demographics, common comorbidities, and treatments prescribed to the patients. RESULTS: The prevalence of BTcP in patients undergoing pelvic 3D external radiotherapy with proctalgia (N = 105) was 48.6% (95% CI 39.0-58.1%). BTcP was further characterized in 59 patients. The mean (± SD) intensity of the BTcP episodes was 7.45 ± 1.47 in a visual analog scale. We found several statistically significant associations between the descriptive variables of BTcP with demographic and clinical variables associated with the tumor or the patient, such as an increased number of BTcP episodes per day depending on the presence or absence of diabetes (p = 0.001, Chi-square) or time to the onset of pain relief depending on the location of the tumor (p = 0.019, Chi-square). Fentanyl was the drug of choice in BTcP episodes for 95% of the patients. CONCLUSIONS: This study demonstrated a high prevalence of BTcP prevalence in cancer patients undergoing pelvic 3D radiotherapy and with proctalgia. Although the variables determining the onset of BTcP are still unclear, our results could help in the design of future clinical studies addressing the treatment of BTcP in these patients. SN - 1699-3055 UR - https://www.unboundmedicine.com/medline/citation/30949931/Prevalence_and_characterization_of_breakthrough_pain_in_cancer_patients_with_proctalgia_treated_with_3D_pelvic_radiotherapy L2 - https://dx.doi.org/10.1007/s12094-019-02102-1 DB - PRIME DP - Unbound Medicine ER -