Quality of Life in Relation to Pain Response to Radiation Therapy for Painful Bone Metastases

Westhoff, Paulien G.; Graeff, Alexander de; Monninkhof, Evelyn M.; Pomp, J.; Vulpen, Marco van; Leer, J.W.H.; Marijnen, Corrie A.M.; Linden, Yvette M. van der

doi:10.1016/j.ijrobp.2015.06.024

Cited by 63 publications

(71 citation statements)

References 35 publications

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“…Moreover, the negative interdependence disclosed by our statistical analysis (r = -0.81, p < 0.005) also confirmed that the drug's effectiveness in terms of pain relief would significantly affect patients' QoL. In fact, scores obtained with the SF-36 suggested a better perception of own health state after treatment, and these results were consistent with the findings reported in literature [22,23]. Nevertheless, patients who received radium-223 before treatment with docetaxel [24] experienced less hematologic toxicity and hospitalization compared to placebo group, whereas patients who received radium-223 after docetaxel [25] showed a higher rate of hematologic toxicity.…”

Section: Discussionsupporting

confidence: 91%

The Clinical Efficacy of Radium-223 for Bone Metastasis in Patients with Castration-Resistant Prostate Cancer: An Italian Clinical Experience

et al. 2017

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Background/Aim: Prostate cancer frequently causes bone metastases and skeletal events that impair quality of life (QoL) and survival. The alpha emitter radium-223 is a new drug that improves treatment in men with castration-resistant prostate cancer (CRPC) and bone metastases. Our aim was to evaluate the effectiveness of radium-223. Subjects and Methods: In this retrospective study we enrolled 48 subjects. Pain reduction, alkaline phosphatase (ALP), time to first symptomatic skeletal event, and QoL were the variables we evaluated. Results: Radium-223 was well tolerated, with a manageable toxicity profile and a modest objective response rate. A considerable difference in serum ALP levels before and after treatment was observed, with a significant correlation between pain relief and QoL, which showed a value of R² to 0.44 with a slope of 1.50 (p = 0.0021). Conclusions: Radium-223 showed a clinical benefit, with a reduction in pain symptoms in 58% of patients. Radium-223 was shown to be an effective and well-tolerated therapeutic option in patients with metastatic CRPC progressing after docetaxel plus prednisone treatment.

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Section: Discussionsupporting

confidence: 91%

The Clinical Efficacy of Radium-223 for Bone Metastasis in Patients with Castration-Resistant Prostate Cancer: An Italian Clinical Experience

et al. 2017

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“…11 The study with the largest patient population exploring QOL changes after radiotherapy to painful bone metastases was a recently published secondary analysis of the Dutch Bone Metastasis Study. 13 Patients were asked to complete several questionnaires, including a pain scale, medication list, the Rotterdam Symptom Checklist, and a visual analog scale for general health weekly for 12 weeks and monthly thereafter until 2 years, death, or study closure. A total of 956 patients accrued between 1996 and 1998 were eligible for analysis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, activity-level impairment deteriorated in nonresponders but remained stable in responders. 13 The authors report that these differences were minimal immediately after radiotherapy and increased with time until 12 weeks after treatment, when significance was evaluated. Although their study was robust, our study found significant differences at earlier time points, namely, at day 10 after treatment for certain components of QOL and at day 42 after treatment for most QOL domains.…”

Section: Discussionmentioning

confidence: 99%

“…9 Because increased pain is associated with a lower QOL in patients with symptomatic bone metastases, 10 a reduction in pain after radiotherapy is hypothesized to translate to an improvement in QOL. A few studies [11][12][13] conducted to date have demonstrated this; however, many involve small patient populations and do not use the bone metastases-specific QOL measurement tools currently available. Furthermore, the time points at which QOL have historically been evaluated are not the same among all studies.…”

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confidence: 99%

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Effect of Radiotherapy on Painful Bone Metastases

et al. 2017

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“…In earlier publications we showed that total QoL and its separate domains, including the psychosocial domain, diminish towards death [14] and that patients responding to radiotherapy have a better QoL than non-responding patients [29]. The aim of the present analysis was to focus on the incidence of PD in patients with painful bone metastases and its course following palliative radiotherapy.…”

Section: Introductionmentioning

confidence: 94%

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

et al. 2017

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Background: Psychological distress (PD) has a major impact on quality of life. We studied the incidence of PD before and after radiotherapy for painful bone metastases. Furthermore, we aimed to identify factors predictive for PD. Methods: Between 1996 and 1998, the Dutch Bone Metastasis Study included 1157 patients with painful bone metastases. Patients were randomized between two fractionation schedules. The study showed a pain response of 74% in both groups. Patients filled out weekly questionnaires for 13 weeks, then monthly for two years. The questionnaires included a subscale for PD on the Rotterdam Symptom Checklist. We used generalized estimating equations and multivariable logistic regression analyses. Results: At baseline, 290 patients (27%) had a high level of PD. For the entire group, the level of PD remained constant over time. The majority of patients with a low level of PD at baseline remained at a low level during follow-up. In patients with a high level of PD at baseline, the mean level of PD decreased after treatment and stabilized around the cutoff level. Female patients, higher age, worse performance, lower pain score and worse self-reported QoL were associated with an increased chance of PD, although the model showed moderate discriminative power. Conclusions: A substantial proportion of patients had a high level of PD before and after radiotherapy for painful bone metastases. Most patients who reported high levels of PD when referred for palliative radiotherapy remained at high levels thereafter. Therefore, screening of PD prior to treatment seems appropriate, in order to select patients requiring intervention.

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Quality of Life in Relation to Pain Response to Radiation Therapy for Painful Bone Metastases

Cited by 63 publications

References 35 publications

The Clinical Efficacy of Radium-223 for Bone Metastasis in Patients with Castration-Resistant Prostate Cancer: An Italian Clinical Experience

The Clinical Efficacy of Radium-223 for Bone Metastasis in Patients with Castration-Resistant Prostate Cancer: An Italian Clinical Experience

Effect of Radiotherapy on Painful Bone Metastases

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

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