title: Breakthrough pain in oncology: a longitudinal study.
abstract: BACKGROUND
  Existing studies on breakthrough pain (BP) have reported different prevalence rates because of different settings, populations, and assessment methods. These studies have used cross-sectional designs, and the relationship of BP with analgesic treatment has not been evaluated.
  
  
  OBJECTIVE
  The aim of this study was to longitudinally assess BP in cancer patients admitted to oncology units.
  
  
  METHODS
  A consecutive sample of patients admitted to oncology centers was selected. At admission (T0), three months after admission (T3), and six months after admission (T6), data on background pain and BP were recorded. BP was assessed in terms of its intensity, duration, number of episodes, onset with movement, spontaneous relief after stopping activity, limitation of physical activity, and effectiveness of analgesics.
  
  
  RESULTS
  Three hundred two patients completed the study. At T0, T3, and T6, 39%, 38%, and 33% patients, respectively, had continuous pain (P=0.294). Pain intensity significantly decreased (P=0.004 and 0.027 at T3 and T6, respectively). Most patients had BP at T0 (87.1%), T3 (80.9%), and T6 (73.2%), and there was a significant decrease in the prevalence of BP over time (P=0.016). Of 149 patients with BP, pain on movement was recorded in 43.6%, 43.4%, and 32.4% at T0, T3, and T6, respectively (P=0.228). Pain spontaneously decreased or ceased when stopping physical activity in 66%, 56%, and 62% at T0, T3, and T6, respectively (P=0.537). Pain on movement strongly limited physical activity in most patients.
  
  
  CONCLUSIONS
  These data expand current information about BP and underline the need for a longitudinal assessment of a phenomenon that is invariably dependent on stage of disease, patient, and therapeutic factors.
authors.affiliation: Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy. terapiadeldolore@lamaddalenanet.it
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Mercadante
authors.forename: Vittoria
authors.initials: V
authors.lastname: Zagonel
authors.forename: Enrico
authors.initials: E
authors.lastname: Breda
authors.forename: Carlo
authors.initials: C
authors.lastname: Arcara
authors.forename: Vittorio
authors.initials: V
authors.lastname: Gebbia
authors.forename: Giampiero
authors.initials: G
authors.lastname: Porzio
authors.forename: Federica
authors.initials: F
authors.lastname: Aielli
authors.forename: Fabrizio
authors.initials: F
authors.lastname: David
authors.forename: Teresa
authors.initials: T
authors.lastname: Gammucci
authors.forename: Filomena
authors.initials: F
authors.lastname: Narducci
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lanzetta
authors.forename: Rossella
authors.initials: R
authors.lastname: Restuccia
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lembo
authors.forename: Virginia
authors.initials: V
authors.lastname: Passeri
authors.forename: Vladimir
authors.initials: V
authors.lastname: Virzì
authors.forename: Alessandra
authors.initials: A
authors.lastname: Casuccio
mesh_terms: D000208:Acute Disease; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000700:Analgesics