Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;29(7):3707-3714.
doi: 10.1007/s00520-020-05887-y. Epub 2020 Nov 16.

Quantitative-qualitative analyses of patient-reported pain response after palliative radiation therapy

Diana D Shi  1 , Tracy A Balboni  2 , Monica S Krishnan  2 , Alexander Spektor  2 , Mai Anh Huynh  2 , Ron Y Shiloh  2 , Sonia Skamene  3 , Cierra Zaslowe-Dude  2 , Lauren M Hertan  4
Affiliations

Quantitative-qualitative analyses of patient-reported pain response after palliative radiation therapy

Diana D Shi et al. Support Care Cancer. 2021 Jul.

Abstract

Purpose: While the 0-10 pain scale is often used to assess treatment response, it may not accurately reflect change in pain over time. The purpose of this study is to correlate pain improvement using the 0-10 pain scale to patients' perceived improvement in pain following palliative radiation therapy (RT), and to qualitatively characterize themes of pain assessment.

Methods: Patients age ≥ 20 receiving RT for spinal metastases were enrolled. Patients rated their pain (0-10) at the treatment site at RT start, and 1 and 4 weeks post-RT completion. At 1 and 4 weeks post-RT, patients reported their perceived percent improvement in pain (pPIP) (0-100%), which was compared to calculated percent improvement in pain (cPIP) based on the 0-10 pain scores. At 4 weeks post-RT, 20 randomly selected patients participated in a qualitative pain assessment.

Results: Sixty-four patients treated at 1-2 sites were analyzed. At 1 week post-RT completion, 53.7% (36/67) reported pPIP within 10 percentage points of cPIP, 32.8% (22/67) reported pPIP > 10 percentage points higher than cPIP, and 13.4% (9/67) reported pPIP > 10 percentage points lower than cPIP. Similar degrees of discordance were seen at 4 weeks post-RT. Qualitative analysis revealed five themes: pain quality (n = 19), activities (n = 9), function (n = 7), medication use (n = 2), and radiation side effects (n = 1).

Conclusions: About half of patients reported a pPIP substantially disparate from their cPIP, and the change in pain measured by the 0-10 scale tended to underestimate the degree of perceived pain improvement. Multiple themes were identified in qualitative analysis of pain response.

Keywords: Pain assessment; Palliative radiation therapy; Spine metastases.

PubMed Disclaimer

References

    1. Coleman RE (2006) Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12:6243 s–6249 s. https://doi.org/10.1158/1078-0432.CCR-06-0931 - DOI
    1. Lutz S, Balboni T, Jones J, Lo S, Petit J, Rich SE, Wong R, Hahn C (2017) Palliative radiation therapy for bone metastases: update of an ASTRO Evidence-Based Guideline. Pract Radiat Oncol 7:4–12. https://doi.org/10.1016/j.prro.2016.08.001 - DOI - PubMed
    1. Hamouda WE, Roshdy W, Teema M (2007) Single versus conventional fractionated radiotherapy in the palliation of painful bone metastases. Gulf J Oncol 1:35–41
    1. Safwat E, El-Nahas T, Metwally H et al (2007) Palliative fractionated radiotherapy for bone metastases clinical and biological assessment of single versus multiple fractions. J Egypt Natl Cancer Inst 19:21–27
    1. Howell DD, James JL, Hartsell WF, Suntharalingam M, Machtay M, Suh JH, Demas WF, Sandler HM, Kachnic LA, Berk LB (2013) Single fraction radiotherapy (SFRT) versus multi-fraction radiotherapy (MFRT) for palliation of painful vertebral bone metastases: equivalent efficacy, less toxicity, more convenient. A subset analysis of RTOG 97-14. Cancer 119:888–896. https://doi.org/10.1002/cncr.27616 - DOI - PubMed

LinkOut - more resources