Donati Costanza M, Zamagni Alice, Zamfir Arina A, Aristei Cynthia, Cammelli Silvia, Zamagni Claudio, Paolinelli Silvia, Buwenge Milly, Rossi Romina, Maltoni Marco, Morganti Alessio G, Cilla Savino
Radiation Oncology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy.
Front Oncol. 2025 Mar 12;15:1536709. doi: 10.3389/fonc.2025.1536709. eCollection 2025.
This ARISE study secondary analysis aims to delve into the complexities of pain management in breast cancer patients undergoing radiotherapy (RT) in Italy. It aims to identify and analyze predictive variables for pain management adequacy and establish the relationship between these variables and the effectiveness of pain control.
This observational study engaged 2,104 participants from 13 Italian RT departments, focusing on 426 breast cancer patients reporting pain. Advanced statistical methods, were employed to identify significant predictive variables for pain management adequacy. Data collection involved a standardized form capturing personal, health-related information, specifics about cancer, pain intensity, and medication. The Pain Management Index (PMI) was used to evaluate pain management adequacy, where negative PMI values indicate inadequate or suboptimal pain management.
The analysis showed that 61.7% of patients experienced inadequate pain management (PMI<0). Factors identified as influencing pain management adequacy included the type of pain, patient age, the objective of RT, and the geographical location of the RT center. Notably, patients undergoing curative RT exhibited a higher incidence of inadequate pain management (PMI<0) compared to those undergoing palliative RT (82.9% versus 31.4%). Geographical variations were evident, with patients treated in northern Italy showing better pain management compared to those in central-southern Italy (72.0% versus 85.6%).
The ARISE study underscores a significant inadequacy in pain management among breast cancer patients undergoing RT in Italy, influenced by a complex interplay of treatment-related, demographic, and regional factors. The study findings emphasize the need for enhanced, personalized pain management strategies and highlight the importance of considering a multifaceted approach.
本ARISE研究的二次分析旨在深入探究意大利接受放射治疗(RT)的乳腺癌患者疼痛管理的复杂性。其目的是识别和分析疼痛管理充分性的预测变量,并确定这些变量与疼痛控制效果之间的关系。
这项观察性研究纳入了来自意大利13个放疗科的2104名参与者,重点关注426名报告疼痛的乳腺癌患者。采用先进的统计方法来识别疼痛管理充分性的显著预测变量。数据收集通过标准化表格进行,涵盖个人、健康相关信息、癌症具体情况、疼痛强度和用药情况。疼痛管理指数(PMI)用于评估疼痛管理的充分性,PMI值为负表明疼痛管理不足或不理想。
分析表明,61.7%的患者疼痛管理不足(PMI<0)。被确定为影响疼痛管理充分性的因素包括疼痛类型、患者年龄、放疗目的以及放疗中心的地理位置。值得注意的是,与接受姑息性放疗的患者相比,接受根治性放疗的患者疼痛管理不足(PMI<0)的发生率更高(82.9%对31.4%)。地域差异明显,意大利北部接受治疗的患者疼痛管理情况优于中南部患者(72.0%对85.6%)。
ARISE研究强调了意大利接受放疗的乳腺癌患者在疼痛管理方面存在显著不足,这受到治疗相关、人口统计学和区域因素的复杂相互作用影响。研究结果强调需要加强个性化的疼痛管理策略,并突出了考虑多方面方法的重要性。