These findings are pivotal in further understanding the meaning of pain intensity levels and the assessment of pain in patients with metastatic cancer. However, further research in alternative methods of defining the optimal CP and clinically important change should be considered.

No abstract

Radiotherapy influenced the structure of symptom clusters in both responders and nonresponders. There was evidence that pain clustered out in responders of radiation to pain. It was found that pain clustered with fatigue, drowsiness, and poor sense of well-being at baseline. However, these findings must be heeded with caution, as more work is needed to clearly define symptom clusters and to understand the effects of radiation in the symptom experience of patients with bone metastases.