Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Department of Radiation Oncology, Arao Municipal Hospital, Arao, Japan.
Radiat Oncol. 2021 Sep 16;16(1):178. doi: 10.1186/s13014-021-01900-8.
There is limited evidence concerning radiotherapy for painful lymph node metastases (PLM). We evaluated the effectiveness of radiotherapy for PLM using the International Consensus Endpoint in a subgroup analysis of a prospective observational study.
In the primary study, 302 patients received radiotherapy for painful tumors. Among them, those treated with palliative radiotherapy for PLM were analyzed in the present study. We used the Brief Pain Inventory short form to evaluate the intensity of pain and the pain interference in patient's life. We collected the Brief Pain Inventory and analgesic data at baseline and at 1, 2, and 3 months after the start of radiotherapy. Pain response was assessed using the International Consensus Endpoint. Patients were diagnosed with a predominance of other pain (POP) if non-index pain of a malignant or unknown origin was present and had a greater 'worst pain' score than the index pain.
Radiotherapy for PLM was performed on 25 patients. In total, 15 (60%) patients experienced a pain response. The pain response rates for evaluable patients were 66%, 67%, and 57% at 1-, 2-, and 3-month follow-ups, respectively. At baseline and at 1, 2, and 3 months, the median index pain scores were 7, 2, 0, and 0.5, respectively. At 1 month, all pain interference scores were significantly reduced from baseline. Four (16%) patients experienced POP within three months.
Radiotherapy for PLM improved pain intensity and pain interference. Palliative radiotherapy may be a viable treatment option for PLM.
针对有疼痛症状的淋巴结转移瘤（PLM）的放射治疗的证据有限。我们在一项前瞻性观察性研究的亚组分析中，使用国际共识终点评估了放射治疗 PLM 的有效性。
在主要研究中，302 例患者接受了针对疼痛性肿瘤的放射治疗。其中，对接受姑息性 PLM 放射治疗的患者进行了本研究的分析。我们使用简明疼痛量表评估疼痛强度和疼痛对患者生活的干扰程度。我们在放射治疗开始前、1 个月、2 个月和 3 个月时收集简明疼痛量表和镇痛数据。使用国际共识终点评估疼痛反应。如果存在恶性或未知来源的非指数疼痛且其“最剧烈疼痛”评分大于指数疼痛，则诊断为主要疼痛以外的疼痛（POP）。
对 25 例 PLM 患者进行了放射治疗。共有 15 例（60%）患者出现疼痛缓解。可评估患者的疼痛缓解率在 1、2 和 3 个月随访时分别为 66%、67%和 57%。在基线和 1、2 和 3 个月时，指数疼痛评分中位数分别为 7、2、0 和 0.5。在 1 个月时，所有疼痛干扰评分均较基线显著降低。在 3 个月内，有 4 例（16%）患者发生 POP。
PLM 的放射治疗改善了疼痛强度和疼痛干扰。姑息性放射治疗可能是 PLM 的一种可行治疗选择。
