Is response to radiotherapy in patients related to the severity of pretreatment pain?
OBJECTIVE
The primary objective of this study was to determine whether there is a relationship between the severity of pretreatment pain and response to palliative radiotherapy (RT) for painful bone metastases.


METHODS
The database for patients with bone metastases seen at the Rapid Response Radiotherapy Program at the Odette Cancer Center from 1999 to 2006 was analyzed. The proportion of patients with mild (scores 1-4), moderate (scores 5-6), or severe (scores 7-10) pain at baseline who experienced a complete response, partial response, stable response, or progressive response after palliative RT was determined according to International Bone Metastases Consensus definitions.


RESULTS
During the 7-year study period 1,053 patients received palliative radiation for bone metastases. The median age was 68 years and the median Karnofsky performance status was 70. Of the patients, 53% had a complete or partial response at 1 month, 52% at 2 months, and 54% at 3 months post-RT.


CONCLUSIONS
There was no significant difference in terms of the proportion of responders (patients with complete or partial response) and nonresponders in terms of painful bone metastases among patients presenting with mild, moderate, or severe pain. Patients with moderate pain should be referred for palliative RT.
Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada.
Andrea
A
Kirou-Mauro
Amanda
A
Hird
Jennifer
J
Wong
Emily
E
Sinclair
Elizabeth A
EA
Barnes
May
M
Tsao
Cyril
C
Danjoux
Edward
E
Chow
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000453:epidemiology / Q000532:radiotherapy* / Q000556:secondary*; D015897:Comorbidity; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D016896:Treatment Outcome