An investigation into the incidence of pain flare in patients undergoing radiotherapy for symptomatic bone metastases.
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Authors
Goldfinch, Rebecca
Issue Date
2018-08-01
Journal
Type
Article
Peer-Reviewed Publication
Peer-Reviewed Publication
Keywords
Analgesia
Bone metastases
Bone neoplasms
Cohort study
Deanesly Centre
External beam radiotherapy (EBRT)
External beam radiotherapy (EBRT)
Oncology
Pain
Pain management
Peer-reviewed article
Prospective study
Radiography
Risk factors
Wolverhampton
Bone metastases
Bone neoplasms
Cohort study
Deanesly Centre
External beam radiotherapy (EBRT)
External beam radiotherapy (EBRT)
Oncology
Pain
Pain management
Peer-reviewed article
Prospective study
Radiography
Risk factors
Wolverhampton
Journal Title
Radiography
Volume
24
Issue
3
Begin page
192
End page
195
Abstract
Introduction: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
Citation
Goldfinch R, White N. An investigation into the incidence of pain flare in patients undergoing radiotherapy for symptomatic bone metastases. Radiography (Lond). 2018 Aug;24(3):192-195.