title: Palliative response and functional interference outcomes using the Brief Pain Inventory for spinal bony metastases treated with conventional radiotherapy.
abstract: OBJECTIVE
  To report pain and functional interference responses in patients radiated for painful spinal metastases, and to determine if location within the vertebral column or dose fractionation are associated with response.
  
  
  METHODS
  Patients treated with palliative radiotherapy for symptomatic spinal metastases from May 2003 to June 2005 were analysed. All patients completed the Brief Pain Inventory (BPI) assessment tool at 1, 2 and 3 months after radiotherapy. The pain response was determined using the International Bone Metastases Consensus response definitions. Given seven BPI functional interference items, a Bonferroni adjusted P value of less than 0.007 was considered significant.
  
  
  RESULTS
  One hundred and nine treated patients were assessed. About 50% of patients were treated with a single fraction of 8Gy. All pain scores and functional interference scores significantly decreased over time after radiotherapy. At 3 months, 64% of patients achieved a response. Mood was significantly improved for responders (P=0.003) and a trend in improvement was observed for general activity (P=0.01) and normal work (P=0.04). Breast and prostate primaries were more likely to achieve an early response as compared with a lung primary. Neither location within the vertebral column or radiotherapy dose fractionation independently predicted for pain or functional interference responses.
  
  
  CONCLUSIONS
  Conventional radiotherapy with 8Gy in a single fraction for spine metastases resulted in effective palliation of pain at 3 months and had a positive effect on a patient's mood. Location within the spine was not a predictive factor.
authors.affiliation: Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Nguyen
authors.forename: E
authors.initials: E
authors.lastname: Chow
authors.forename: L
authors.initials: L
authors.lastname: Zeng
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.forename: S
authors.initials: S
authors.lastname: Culleton
authors.forename: L
authors.initials: L
authors.lastname: Holden
authors.forename: G
authors.initials: G
authors.lastname: Mitera
authors.forename: M
authors.initials: M
authors.lastname: Tsao
authors.forename: E
authors.initials: E
authors.lastname: Barnes
authors.forename: C
authors.initials: C
authors.lastname: Danjoux
authors.forename: A
authors.initials: A
authors.lastname: Sahgal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000532:radiotherapy; D010147:Pain Measurement / Q000379:methods*; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D013125:Spinal Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000556:secondary*