Pain relief from palliative RT for bone metastases improves QoL

By Sarah Guy, medwireNews Reporter

Cancer patients who experience pain relief after palliative radiation therapy (RT) for bone metastases report a better quality of life (QoL) on specific bone metastases measures than their peers who do not respond to treatment, show study results.

Responders had lower painful site, painful characteristics, and overall pain scores, and better physical and role functioning than nonresponders, report the researchers in the International Journal of Radiation Oncology, Biology, Physics.

They measured QoL using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for patients with Bone Metastases (EORTC QLQ-BM22), adding further detail to the validity of the tool to distinguish between patients who did and did not respond to treatment.

"Our results suggest that palliation of painful bone metastases improves QoL issues that are directly related to the pain and physical interferences that it causes," remark Edward Chow (Sunnybrook Health Sciences Center, Toronto, Ontario, Canada) and colleagues.

In all, 59 advanced cancer patients who received palliative RT between March 2010 and January 2011 participated in the study. They were situated in six countries and were aged a mean of 63 years.

The most common cancer types were breast (26.6%), prostate (21.5%), and lung (20.2%). In all, 37.2%, 13.6%, and 49.2% of patients had a partial response (a reduction in pain score without increase of analgesics), pain progression, and an indeterminate response to RT, respectively.

At the 1-month follow up, patients with a partial response to RT showed a significant improvement in painful site, painful characteristic, and pain scores on the QLQ-BM22 compared with their counterparts whose pain progressed or who had an indeterminate response. Specifically, these groups' respective mean change scores were -22.7, -36.4, and -40.9 points versus -9.2, -5.6, and 6.3 points, and 1.8, -1.9, and -2.9 points.

Similarly, physical and role functioning - assessed using the EORTC Quality of Life Questionnaire for cancer patients (QLQ C30) - improved significantly in the partial responders (mean changes in score of 16.7 and 20.5) but not in those whose pain progressed (mean score changes of -7.9 and -8.3) or who had indeterminate responses (mean score change of -3.1 and -4.0).

The first group also had significantly less functional interference from their bone metastases than the last two groups.

Psychosocial, emotional, and social functioning scores did not differ significantly according to patient response, report Chow and team, indicating that "they are not completely influenced by pain alone," they suggest.

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