Sequeira Maria Inês, Sousa Nuno, Fragoso Maria, Silva Alexandra, Pereira Filipa, Azevedo Luís
Serviço de Oncologia Médica. Instituto Português de Oncologia do Porto Francisco Gentil. Porto. Portugal.
Enfermagem. Instituto Português de Oncologia do Porto Francisco Gentil. Porto. Portugal.
Acta Med Port. 2017 Nov 29;30(11):796-804. doi: 10.20344/amp.8820.
Pain is one of the most common symptoms reported by cancer patients and is associated with decreased quality of life. Assessment of pain with standardized questionnaires reduces variability in its interpretation and may increase effectiveness of medical interventions. Prostate cancer is the most frequent male neoplasm in Portugal. We designed this study to evaluate the impact of a standardized pain questionnaire on pain management in patients with metastatic prostate cancer.
Single centre prospective observational study of patients with metastatic prostate cancer. The study was designed to evaluate the benefit of systematically evaluating pain with Brief Pain Inventory-Short Form prior to a scheduled medical oncology consult. Patients reporting pain were reassessed one week later by telephone. To assess the benefit two consecutive cohorts were established based on communication of questionnaire results to the treating physician.
We recruited 207 patients of which 60% reported pain. Statistically significant decrease in mean pain intensity one week after the scheduled appointment was noted (3.95 vs 3.01; p < 0.001). Patients whose Brief Pain Inventory-Short Form was provided to their oncologist experienced greater reduction in pain, which was non-significant (p = 0.227). Using Brief Pain Inventory-Short Form assessment resulted in a higher probability of pain control (43.5% vs 30.9%; p = 0.193).
The prevalence of pain founded was higher than described in the literature, probably because our sample was less selected than the published in clinical trials. After the scheduled appointment, there was a statistically significant reduction in mean pain intensity, but the explicit use of this questionnaire was not associated with a statistically significant reduction of pain.
Patients with metastatic prostate cancer have a high prevalence of pain. Evaluation and treatment by medical oncologists is associated with a reduction of mean pain intensity. The use of Brief Pain Inventory-Short Form was associated with a non-significant increased reduction of pain.
疼痛是癌症患者报告的最常见症状之一，与生活质量下降相关。使用标准化问卷评估疼痛可减少其解读的变异性，并可能提高医疗干预的有效性。前列腺癌是葡萄牙最常见的男性肿瘤。我们设计本研究以评估标准化疼痛问卷对转移性前列腺癌患者疼痛管理的影响。
对转移性前列腺癌患者进行单中心前瞻性观察研究。该研究旨在评估在预定的肿瘤内科会诊前，使用简明疼痛问卷简表系统评估疼痛的益处。报告疼痛的患者在一周后通过电话进行重新评估。为评估益处，根据问卷结果向治疗医生传达的情况建立了两个连续队列。
我们招募了207名患者，其中60%报告有疼痛。在预定会诊一周后，平均疼痛强度有统计学显著下降（3.95对3.01；p<0.001）。其简明疼痛问卷简表被提供给肿瘤医生的患者疼痛减轻幅度更大，但无统计学显著性（p = 0.227）。使用简明疼痛问卷简表评估导致疼痛得到控制的可能性更高（43.5%对30.9%；p = 0.193）。
所发现的疼痛患病率高于文献中描述的，可能是因为我们的样本选择不如临床试验中发表的那样严格。在预定会诊后，平均疼痛强度有统计学显著下降，但明确使用该问卷与疼痛的统计学显著减轻无关。
转移性前列腺癌患者疼痛患病率高。肿瘤内科医生的评估和治疗与平均疼痛强度降低相关。使用简明疼痛问卷简表与疼痛减轻幅度的非显著性增加相关。
