Goldfinch R, White N
Royal Wolverhampton NHS Trust, Deanesly Centre, New Cross Hospital, Wolverhampton WV10 0QP, UK.
Department of Radiography, Birmingham City University, B15 3TN, UK.
Radiography (Lond). 2018 Aug;24(3):192-195. doi: 10.1016/j.radi.2018.01.010. Epub 2018 Feb 21.
External Beam Radiotherapy (EBRT) is a recognised intervention for symptomatic pain relief from bone metastases. Pain flare is a reported EBRT toxicity, described in 16-41% of steroid-naïve patients. This study aimed to determine incidence and duration of pain flare amongst patients within one Oncology Centre.
Patients receiving EBRT for bone metastases were recruited to a prospective cohort study. Baseline pain scores and a daily pain/analgesia diary were recorded during EBRT and for 14 days thereafter. Pain flare was defined as a two-point increase on a pain scale or 25% increase in analgesia intake, with a return to baseline.
Of the thirty-two participants, 69% (n = 22) completed the diary. 41% (n = 9) patients experienced pain flare, the median duration being 3 days. Of the evaluable patients, 55% (n = 12) were male, 45% (n = 9) female. The median age was 73 years (range 40-83). The common primary sites of disease were Breast (32%) and Prostate (32%), with other sites making up the remaining 36%. The most frequent EBRT site was the spine (63%), with other treatment sites including pelvis (23%) and extremities (14%). EBRT regimes were restricted to 20 Gy in 5 treatments, received by 32% (n = 7) of patients and 8 Gy in 1 treatment (68% (n = 14)). Of these two regimes, pain flare was reported by 29% and 47% respectively.
Pain flare is a common toxicity of EBRT for bone metastases. Taking the small sample size into consideration, the incidence and duration of pain flare in patients within this single-centre study are comparable with those found in international studies.
外照射放疗（EBRT）是一种公认的用于缓解骨转移引起的症状性疼痛的干预措施。疼痛加剧是一种已报道的EBRT毒性反应，在16%-41%未使用过类固醇的患者中有所描述。本研究旨在确定某肿瘤中心内患者疼痛加剧的发生率和持续时间。
招募接受EBRT治疗骨转移的患者进行前瞻性队列研究。在EBRT期间及之后14天记录基线疼痛评分和每日疼痛/镇痛日记。疼痛加剧定义为疼痛量表上增加两分或镇痛药物摄入量增加25%，并恢复至基线水平。
32名参与者中，69%（n = 22）完成了日记记录。41%（n = 9）的患者经历了疼痛加剧，中位持续时间为3天。在可评估的患者中，55%（n = 12）为男性，45%（n = 9）为女性。中位年龄为73岁（范围40-83岁）。常见的原发疾病部位为乳腺癌（32%）和前列腺癌（32%），其他部位占其余36%。最常见的EBRT部位是脊柱（63%），其他治疗部位包括骨盆（23%）和四肢（14%）。EBRT方案限于5次治疗共20 Gy，32%（n = 7）的患者接受此方案，1次治疗8 Gy（68%（n = 14））。在这两种方案中，分别有29%和47%的患者报告了疼痛加剧。
疼痛加剧是EBRT治疗骨转移常见的毒性反应。考虑到样本量较小，本单中心研究中患者疼痛加剧的发生率和持续时间与国际研究结果相当。
