Department of Internal Medicine, Gyeongsang National University, Jinju, Republic of Korea.
Department of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Republic of Korea.
Support Care Cancer. 2020 Nov;28(11):5177-5183. doi: 10.1007/s00520-020-05329-9. Epub 2020 Feb 14.
To investigate the association between quality of life (QOL) and breakthrough cancer pain (BTCP) intensity in patients who met the commonly accepted definition of BTCP.
This study was a subset analysis of a South Korean multicenter, non-interventional, cross-sectional, nationwide survey. Participants were recruited from March 2016 to December 2017. BTCP was defined as a controlled background pain of less than a numeric rating scale (NRS) of 3 and any flare-up pain intensity. Pain intensity data were collected using the Brief Pain Inventory (BPI), which includes an interference assessment of the affective and physical domains. Patients were categorized by BTCP intensity into mild (NRS 1-3), moderate (4-6), and severe (7-10) groups.
Of the 969 screened patients with cancer, 679 had ≤ NRS 3 background pain, of whom 438 completed the BPI. Of these 438 patients, 40, 204, and 194 were in the mild, moderate, and severe BTCP groups, respectively. The median NRS of BTCP was 6.0 (interquartile range = 5.0-8.0). Patients with moderate-severe BTCP had significantly higher interference with daily functioning (IDF) scores than did mild BTCP patients (3.3 vs. 5.7; p < 0.01). Both domains of IDF were significantly hampered proportionally by increased BTCP intensity (p < 0.001). The median total IDF scores of the no, moderate, and severe BTCP groups were 3.3, 5.0, and 6.9, respectively. Furthermore, IDF depended on BTCP intensity, duration, and frequency (p < 0.01) but not on pain type and cause.
An increase in BTCP intensity is likely to result in IDF, regardless of the cause or type of BTCP.
调查符合普遍接受的 BTCP 定义的患者生活质量（QOL）与突破性癌痛（BTCP）强度之间的关系。
本研究是一项韩国多中心、非干预性、横断面、全国性调查的亚组分析。参与者于 2016 年 3 月至 2017 年 12 月期间招募。BTCP 定义为数字评定量表（NRS）小于 3 的控制背景疼痛和任何加剧疼痛强度。疼痛强度数据使用简明疼痛量表（BPI）收集，其中包括情感和身体领域的干扰评估。患者根据 BTCP 强度分为轻度（NRS 1-3）、中度（4-6）和重度（7-10）组。
在 969 名筛查出患有癌症的患者中，有 679 名患者的背景疼痛≤NRS 3，其中 438 名完成了 BPI。在这 438 名患者中，分别有 40、204 和 194 名患者处于轻度、中度和重度 BTCP 组。BTCP 的中位 NRS 为 6.0（四分位间距=5.0-8.0）。中重度 BTCP 患者的日常功能干扰（IDF）评分明显高于轻度 BTCP 患者（3.3 对 5.7；p<0.01）。随着 BTCP 强度的增加，两个 IDF 域都受到显著阻碍（p<0.001）。无、中、重度 BTCP 组的中位总 IDF 评分分别为 3.3、5.0 和 6.9。此外，IDF 取决于 BTCP 强度、持续时间和频率（p<0.01），但与疼痛类型和原因无关。
无论 BTCP 的原因或类型如何，BTCP 强度的增加都可能导致 IDF。
