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Observational Study
. 2021 Sep 16;16(1):178.
doi: 10.1186/s13014-021-01900-8.

Palliative radiotherapy for painful lymph node metastases

Kohsei Yamaguchi  1   2   3 , Tetsuo Saito  4 , Ryo Toya  5   6 , Etsushi Tomitaka  7 , Tomohiko Matsuyama  5 , Yoshiyuki Fukugawa  5   6 , Takahiro Watakabe  5   6 , Hirohito Otsuka  5   7 , Natsuo Oya  5
Affiliations
Observational Study

Palliative radiotherapy for painful lymph node metastases

Kohsei Yamaguchi et al. Radiat Oncol. .

Abstract

Background: There is limited evidence concerning radiotherapy for painful lymph node metastases (PLM). We evaluated the effectiveness of radiotherapy for PLM using the International Consensus Endpoint in a subgroup analysis of a prospective observational study.

Methods: In the primary study, 302 patients received radiotherapy for painful tumors. Among them, those treated with palliative radiotherapy for PLM were analyzed in the present study. We used the Brief Pain Inventory short form to evaluate the intensity of pain and the pain interference in patient's life. We collected the Brief Pain Inventory and analgesic data at baseline and at 1, 2, and 3 months after the start of radiotherapy. Pain response was assessed using the International Consensus Endpoint. Patients were diagnosed with a predominance of other pain (POP) if non-index pain of a malignant or unknown origin was present and had a greater 'worst pain' score than the index pain.

Results: Radiotherapy for PLM was performed on 25 patients. In total, 15 (60%) patients experienced a pain response. The pain response rates for evaluable patients were 66%, 67%, and 57% at 1-, 2-, and 3-month follow-ups, respectively. At baseline and at 1, 2, and 3 months, the median index pain scores were 7, 2, 0, and 0.5, respectively. At 1 month, all pain interference scores were significantly reduced from baseline. Four (16%) patients experienced POP within three months.

Conclusion: Radiotherapy for PLM improved pain intensity and pain interference. Palliative radiotherapy may be a viable treatment option for PLM.

Keywords: Pain interference; Painful lymph node metastases; Palliative radiotherapy; Predominance of other pain.

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Conflict of interest statement

Not applicable.

Figures

Fig. 1
Fig. 1
Flow diagram of the study cohort
Fig. 2
Fig. 2
Pain interference score at baseline and at 1, 2 and 3 months of follow-up. The Wilcoxon signed-rank test was used to compare between two time points (i.e., the radiotherapy initiation versus 1, 2 or 3 months thereafter). RT, radiotherapy
Fig. 3
Fig. 3
Waterfall plot of percentage change from baseline to one month follow-up in mean pain interference score. CR, complete response PR, partial response IR, indeterminate response PP, pain progression
See this image and copyright information in PMC

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