Improvements in Health-Related Quality of Life by Comprehensive Cancer Pain Therapy: A Pilot Study with Breast Cancer Outpatients under Palliative Chemotherapy

Puetzler, Jan; Feldmann, Robert; Bräscher, Anne-Kathrin; Gerhardt, Axel; Benrath, Justus

doi:10.1159/000365537

Cited by 32 publications

(14 citation statements)

References 26 publications

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“…4 Undertreatment of CP generates distress and impairs quality of life for patients. 5,6 Although evidence-based guidelines on therapeutic interventions exist, 7,8 data indicate that CP remains undertreated worldwide. 9,10 Inadequate assessment has been identified as a major contributor to undertreatment.…”

Section: Introductionmentioning

confidence: 99%

Cancer-Related Pain: A Longitudinal Study of Time to Stable Pain Control and Its Clinicodemographic Predictors

Reis-Pina

Sabri

Birkett

et al. 2019

Journal of Pain and Symptom Management

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Context. Multidimensional assessment is pivotal in managing cancer-related pain. Objectives. The objectives of this study were to determine time to stable pain control (SPC) and identify its baseline clinicodemographic predictors in patients with cancer pain. Methods. This is a prospective longitudinal study of patients attending a cancer pain clinic. Scheduled clinic attendances and weekly investigator-led phone calls enabled monitoring of patients' daily pain diary, opioid use, and other analgesic interventions. Baseline clinicodemographic variables were examined in survival analyses, which included the construction of accelerated failure time models with time ratios [TRs, (95% CIs)], based on time to SPC (pain intensity #3 and <3 breakthrough opioid doses over three consecutive days) for variable categories. Results. Of 319 participants, 22 died before achieving SPC and were censored in the survival analysis. The median survival time (95% CI) to SPC was 22 (19e25) days. In multivariable analysis, compared to their respective reference categories, female sex (P ¼ 0.001), substance abuse (P < 0.001), a neuropathic pain component (P < 0.001), and use of $1 adjuvant analgesic (P ¼ 0.022) each had TRs > 1 (1.03e2.54), whereas soft tissue pain (P < 0.001) had a TR ¼ 0.71 (0.62e0.82), reflecting longer and shorter time to SPC, respectively. Conclusion. SPC is achievable for most patients with cancer pain. Recognition of strong predictors of time to SPC, such as substance abuse, a neuropathic pain component, soft tissue pain, and current use of adjuvant analgesia, may help to triage care services based on therapeutic need and guide analgesic interventions.

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Section: Introductionmentioning

confidence: 99%

Cancer-Related Pain: A Longitudinal Study of Time to Stable Pain Control and Its Clinicodemographic Predictors

Reis-Pina

Sabri

Birkett

et al. 2019

Journal of Pain and Symptom Management

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“…These findings were confirmed by the results of Kroenke and Theobald [ 56 ]. Many studies also demonstrate that pain in breast cancer is associated with a lower HRQOL, especially in high levels of pain severity and pain interference, while good pain management led to an improved QOL [ 42 , 57 , 58 ]. Pain interference mostly affected normal work, walking ability, mood, sleep and general activity.…”

Section: Discussionmentioning

confidence: 99%

Cancer-related post-treatment pain and its impact on health-related quality of life in breast cancer patients: a cross sectional study in Palestine

et al. 2017

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BackgroundPost-treatment pain has been suggested as an important indicator for health-related quality of life (HRQOL) in patients with breast cancer. Therefore, this study was performed to examine the association between pain and its impact on HRQOL among breast cancer patients in Palestine. Also, this study aimed to determine the QOL profile for breast cancer patients and stated the factors associated with QOL.MethodsA correlational cross-sectional study was conducted from May 2016 to November 2016 at Al-Watani Hospital and An-Najah National University Hospital in the Nablus district in Palestine. The five-level EuroQol five-dimensional instrument (EQ-5D-5L) was used to examine HRQOL. Pain severity and interference were assessed using the Brief Pain Inventory (BPI). Multiple linear regression analysis was performed to determine the most important variables related with HRQOL.ResultsOne hundred and seventy patients were involved in this study. Overall, all participants were female, with a mean ± SD for age of 51.71 ± 11.11 years. The reported HRQOL of this study was measured by using the median EQ-5D-5L index score, which was 0.67 (interquartile range: 0.51–0.84). There were moderate negative correlations between EQ-5D-5L index score and pain severity score (r = − 0.58, p value < 0.001), and pain interference score (r = − 0.604, p-value < 0.001). Furthermore, univariate analysis showed that age, marital status, employment status, income, current condition of cancer, and post-treatment pain were associated with quality of life (p-value < 0.05). Regression analysis revealed that patients with high income (p-value = 0.003), patients with lower pain severity score (p-value < 0.001), and lower pain interference score (p-value = 0.018) were independently associated with high QOL.ConclusionsThis is the first study to present important data regarding QOL by using the EQ-5D-5L instruments that may help healthcare providers to identify patients at risk of low QOL. Healthcare providers and health strategy makers should be alerted to low level HRQOL among breast cancer patients with low income level, patients with post-treatment pain, especially in the state of severe pain, and the state of pain interfering with daily life to improve their HRQOL.

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“…A previous study indicates that fatigue, mucosal inflammation, proteinuria, hypertension, as well as gastrointestinal toxicity, occurred at a low frequency (32). Another previous study indicated that proteinuria, hypertriglyceridemia, diarrhea, and fatigue were the most common treatment-related TEAEs (33).…”

Section: Discussionmentioning

confidence: 99%

Preclinical trial of the multi-targeted lenvatinib in combination with cellular immunotherapy for treatment of renal cell carcinoma

Cai

Tang

Shen

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Lenvatinib is an oral, multi-targeted tyrosine kinase inhibitor of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor β, RET and KIT. Cellular immunotherapy has the potential to be a highly targeted treatment, with low toxicity to normal tissues and a high capacity to eradicate tumor tissue. The present study assessed the safety, maximum tolerated dose (MTD) and preliminary antitumor activity of lenvatinib and cellular immunotherapy in a murine model of renal cell carcinoma (RCC). The present study used a therapeutic dose of 0.12 mg lenvatinib and/or 10 4 rat uterine cancer adenocarcinoma (RuCa)-sensitized lymphocytes administered once daily continuously in 7-day cycles. Tumor regression was observed in mice with RCC following treatment with lenvatinib and 10 4 RuCa-sensitized lymphocytes. MTD was established as once daily administration of 0.18 mg lenvatinib and 10 6 RuCa-sensitized lymphocytes. The most common treatment-related adverse effects observed were fatigue (40%), mucosal inflammation (30%), proteinuria, diarrhea, vomiting, hypertension and nausea (all 40%). Combination therapy using lenvatinib and cellular immunotherapy enhanced the antitumor effect induced by single treatments and prolonged the survival of mice with RCC compared with either of the single treatments. Treatment with lenvatinib (0.12 mg) combined with 10 4

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Improvements in Health-Related Quality of Life by Comprehensive Cancer Pain Therapy: A Pilot Study with Breast Cancer Outpatients under Palliative Chemotherapy

Cited by 32 publications

References 26 publications

Cancer-Related Pain: A Longitudinal Study of Time to Stable Pain Control and Its Clinicodemographic Predictors

Cancer-Related Pain: A Longitudinal Study of Time to Stable Pain Control and Its Clinicodemographic Predictors

Cancer-related post-treatment pain and its impact on health-related quality of life in breast cancer patients: a cross sectional study in Palestine

Preclinical trial of the multi-targeted lenvatinib in combination with cellular immunotherapy for treatment of renal cell carcinoma

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