title: Improvement in sensory pain rating after palliative systemic radionuclide therapy in patients with advanced prostate cancer.
abstract: This study assessed whether baseline and short-term patient-reported quality of life (QOL) differs in patients with symptomatic metastatic prostate cancer undergoing palliative management using opioids, nonsteroidal anti-inflammatory agents (NSAIDs), (89)strontium chloride ((89)Sr), and samarium-lexidronam ((153)Sm). Males were grouped according to primary palliative intervention: opioids (n = 40), NSAIDs (n = 40), (89)Sr chloride (n = 25), and (153)Sm (n = 25). The short form of the self-administered McGill Pain Questionnaire was used to measure QOL at baseline, 4 and 8 weeks after initiation of treatment. Clinical data were collected from patients' medical records. Statistical analyses were conducted using descriptive methods and the Student t test. A significant increase in the sensory pain rating was observed in the patients treated by NSAIDs ([upward arrow]21%) and (89)Sr ([upward arrow]46%), whereas those treated by opioids ([downward arrow]27%) and (153)Sm ([downward arrow]27%) demonstrated a significant (P < 0.05) decrease in this subscore. There was a longitudinal decrease in QOL over time in patients treated by NSAIDs and (89)Sr as measured by the total pain rating score, whereas those treated with the other agents experienced improved QOL. This study demonstrates improvement in QOL achieved using (153)Sm, which is comparable to that achieved with the use of opioids during this observation interval.
authors.affiliation: Division of Health Policy Department of Radiology, University of California San Diego, San Diego, CA, USA.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Papatheofanis
authors.forename: Cynthia
authors.initials: C
authors.lastname: Smith
authors.forename: Mohammad
authors.initials: M
authors.lastname: Najib
mesh_terms: D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009942:Organometallic Compounds / Q000627:therapeutic use; D009943:Organophosphorus Compounds / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D010166:Palliative Care; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life; D013324:Strontium / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; C061972:samarium Sm-153 lexidronam; C025700:strontium chloride; D013324:Strontium