To What Extent Does Radiotherapy Improve the Quality of Life of Patients With Bone Metastasis?

Arias, Fernando; Arrarás, Juan Ignacio; Asin, Gemma; Zarandona, Unai Irusta; Mora, I.; Errasti, M.; Barrado, M.; Campo, M.; Visus, I.; Dominguez, Miguel A.

doi:10.1097/coc.0000000000000249

Cited by 12 publications

(11 citation statements)

References 13 publications

(15 reference statements)

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“…This reinforces the current notion that despite its importance, insomnia remains a neglected topic in palliative care 51,86,87 even in studies aiming to explore the palliative patients’ quality of life. 88 -90 Encountered prevalence variation (2.1%-100%) is remarkable and can be explained by the variety of study designs, used definitions, and evaluation instruments. For instance, prospective studies that considered a broader definition of insomnia, with inclusion of minor manifestations, reported higher prevalences 8,19,70 while those with more restrictive criteria registered lower ones.…”

Section: Methodsmentioning

confidence: 99%

Systematic Review of the Prevalence, Predictors, and Treatment of Insomnia in Palliative Care

Nzwalo

Aboim²,

Joaquim

et al. 2020

Am J Hosp Palliat Care

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Introduction: The primary function of palliative care is to improve quality of life. The recognition and treatment of symptoms causing suffering is central to the achievement of this goal. Insomnia reduces quality of life of patients under palliative care. Knowledge about prevalence, associated factors, and treatment of insomnia in palliative care is scarce. Methodology: Literature review about the prevalence, predictors, and treatment options of insomnia in palliative care patients. Primary sources of investigation were identified and selected through Pubmed and Scopus databases. The research was complemented by reference search in identified articles and selected reviews. OpenGrey and Google Scholar were used for searching grey literature. Study quality analysis was based on the Newcastle-Ottawa Scale. Results: A total of 65 studies were included in the review. Most studies had acceptable /good quality. The prevalence of insomnia in the included studies ranged from 2.1% to 100%, with a median overall prevalence of 49.5%. Sociodemographic factors such as age; clinical characteristics such as functional status, disease stage, pain, and use of specific drugs, including opioids; psychological factors such as anxiety/depression; and spiritual factors such as feelings of well-being were identified as predictors. The treatment options identified were biological (pharmacological and nonpharmacological), psychological (visualization, relaxation), and spiritual (prayer). Conclusions: The systematic review showed that the prevalence of insomnia is high, with at least one in 3 patients affected in most studies. Insomnia’s risk factors and treatment in palliative care are both associated to physical, psychological, social, and spiritual factors, reflecting its true holistic nature.

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Section: Methodsmentioning

confidence: 99%

Systematic Review of the Prevalence, Predictors, and Treatment of Insomnia in Palliative Care

Nzwalo

Aboim²,

Joaquim

et al. 2020

Am J Hosp Palliat Care

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“…Other factors (e.g. frequency of hospital visits and treatment tolerability) must also be taken into account when considering the overall QoL of a patient receiving radiotherapy [67,68].…”

Section: Radiotherapymentioning

confidence: 99%

Improving quality of life in patients with advanced cancer: Targeting metastatic bone pain

Moos

Costa

Ripamonti

et al. 2017

European Journal of Cancer

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Metastatic bone disease in patients with advanced cancer is frequently associated with skeletal complications. These can be debilitating, causing pain, impaired functioning and decreased quality of life, as well as reduced survival. This review considers how the management of metastatic bone pain might be optimised, to limit the considerable burden it can impose on affected patients. Cancer-related pain is notoriously under-reported and under-treated, despite the availability of many therapeutic options. Non-opioid and opioid analgesics can be used; the latter are typically administered with radiotherapy, which forms the current standard of care for patients with metastatic bone pain. Surgery is appropriate for certain complicated cases of metastatic bone disease, and other options such as radiopharmaceuticals may provide additional relief. Treatments collectively referred to as bone-targeted agents (BTAs; bisphosphonates and denosumab) can offer further pain reduction. Initiation of therapy with BTAs is recommended for all patients with metastatic bone disease because these agents delay not only the onset of skeletal-related events but also the onset of bone pain. With evidence also emerging for pain control properties of new anticancer agents, the potential to individualise care for these patients is increased further. Optimisation of care depends on physicians' thorough appreciation of the complementary benefits that might be achieved with the various agents, as well as their limitations. Appropriate anti-tumour treatment combined with early initiation of BTAs and adequate analgesia plays a key role in the holistic approach to cancer pain management and may minimise the debilitating effects of metastatic bone pain.

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“…Combination of opioids and radiotherapy could prove effective in pain relief in patients with metastatic bone disease 17 , but frequent visits to the hospital and tolerance in drugs should be taken in consideration to evaluate QoL. 18 Bone targeted therapies like bisphosphonate and denosumab show high specialty in treating skeletal events and pain due to metastasis. 19 They are administered to patients with mild pain in order to treat, or prevent, bone metastasis, reducing the need of strong opioids.…”

Section: Introductionmentioning

confidence: 99%

Monitoring changes in quality of life in patients with lung cancer under treatment with chemotherapy and co administration of zoledronic acid by using specialized questionnaires

Tremmas¹,

Petsatodis²,

Potoupnis³

et al. 2018

J. Cancer

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Background: Due to the severity of the primary disease in patients with lung cancer, quality of life (QoL) is often overlooked. Factors that form QoL should be taken in consideration when planning the appropriate treatment and determining therapy targets, because of the increasing frequency of bone metastasis leading to high levels of pain. Purpose of this study is to assess quality of life in patients with lung cancer, before and after treatment combined with zoledronic acid.Methods and materials: QoL was assessed in 80 patients (49 males-31 females), of which 45 developed bone metastasis. Prior and post treatment (with co administration of zoledronic acid) seven reliable scales: Pittsburgh Sleep Quality index (PSQI), Epworth Sleeping Scale (ess), Dyspnea Scale (ds), Fatigue Severity Scale (FSS), Brief Pain Inventory (BPI), Fact-G scale for sleep quality and EQ-5D for general health condition.Results: Statistically positive correlations were verified between PSQI-DS, PSQI-FSS, BPI-ESS, DS-FSS, DS-BPI and BPI-FSS (p<0,005) prior and post treatment. Patients sleep quality was improved, pain levels decreased and betterment in quality of life was marked (p<0,001). Although significant decrease in fatigue levels was observed (p<0,001) there has been an increase in dyspnea symptoms (p<0,001).Conclusions: Significant improvement was apparent when zoledronic acid was co administered in any treatment in patients with lung cancer. Sleep quality, fatigue and pain parameters also improved, with no positive impact on the symptoms of dyspnea.

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To What Extent Does Radiotherapy Improve the Quality of Life of Patients With Bone Metastasis?

Cited by 12 publications

References 13 publications

Systematic Review of the Prevalence, Predictors, and Treatment of Insomnia in Palliative Care

Systematic Review of the Prevalence, Predictors, and Treatment of Insomnia in Palliative Care

Improving quality of life in patients with advanced cancer: Targeting metastatic bone pain

Monitoring changes in quality of life in patients with lung cancer under treatment with chemotherapy and co administration of zoledronic acid by using specialized questionnaires

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