Pain figures are unsuitable for determination of palliative radiotherapy portals in patients with hormone refractory prostatic cancer.
We aimed to compare bone scintigraphy with pain extension and other quality of life (QoL) factors in order to evaluate QoL and the appropriateness of using pain figures and a subjective pain description as the basis for palliative radiotherapy (RT) portals. Twenty-three patients with progressive hormone-refractory prostatic adenocarcinoma were investigated with bone scintigraphy and completed pain figures, VAS (visual analogue scales) and a comprehensive self-questionnaire concerning QoL. The Soloway score was significantly correlated with Impaired overall QoL (p = 0.05), and especially with questions regarding restriction of movements (p = 0.001). Weight bearing regions were significantly more often affected at bone scintigraphy than other locations in the group of patients reporting incidental pain during exercise. Surprisingly, a poor level of correlation existed when comparing location of pain with location of uptake on bone scintigraphy, even if an adjacent region was included in the comparison. The subjective description of pain extension in pain figures correlates poorly with the uptake patterns at bone scintigraphy--an interesting finding since pain extensions is regularly used for the definition of palliative RT portals. Furthermore, it appears that the tumour burden itself is not and indicator of the pain score at rest, but affects aspects of QoL. Moreover, it would appears as though the location of metastases in the skeleton significantly affects physical quality of life aspects. It is probably more important to irradiate weight bearing regions of skeleton in order to increase QoL.
Department of Oncology, University of Uppsala Hospital, Sweden.
K M
KM
Kälkner
J E
JE
Westlin
S
S
Nilsson
P
P
Strang
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D019008:Drug Resistance, Neoplasm; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement; D010166:Palliative Care; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011788:Quality of Life; D011877:Radionuclide Imaging; D011795:Surveys and Questionnaires
D007987:Gonadotropin-Releasing Hormone