Prospective surveillance of patients after palliative radiation for painful bone metastases: a feasibility study.

4区医学 Q2 Nursing

Annals of palliative medicine Pub Date : 2024-09-01 Epub Date: 2024-09-12 DOI:10.21037/apm-24-10

Lorna McLean-Thomas, Kareem Fakhoury, Richard Blake Ross, Rhonda Mahoney, Nicholas Gortmaker, Junxiao Hu, Sana D Karam

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引用次数: 0

Abstract

Background: Bone metastasis is the most common cause of cancer-related pain. Radiation therapy (RT) can provide successful palliation but there is currently no consensus for surveillance after palliative radiation. This study aimed to assess the feasibility of surveillance after RT for painful bone metastases.

Methods: The study took place in an academic cancer center. Patient feasibility measures included % of calls answered, ease of recruitment and study retention. Clinician measures included % of calls made within 3 days, call time and qualitative feedback. Patients were identified with a painful bone metastasis treated with RT. The bone metastasis had a worst pain score of at least 4 (0-10 scale), with pain localized to a radiographically confirmed lesion. Patients were called at weeks 1, 4 and 8 following RT. Pain response and opioid use were assessed. Quality of life was assessed using a validated questionnaire. Descriptive statistics were used to assess if these metrics were met for patients and clinicians over 8 weeks post-RT.

Results: Twenty patients were consented: 14 participants completed treatment and were not hospitalized or deceased prior to week 1. The patients were 50% male and 50% female. Recruitment was completed quickly, with no patients withdrawing. Response rate was week 1: 85% week 4: 83% and week 8: 83%. Six patients were referred back to their provider for pain management. Calls were made to patients within 3 days a median of 63% of the time (range, 40-82%), with a median call time of 16 (range, 8-42) minutes. Call lengths were longer for patients who required interpretation. Nurse feedback highlighted length of call and nursing time available as limitations.

Conclusions: All patient feasibility measures were met. Six patients required further pain management, highlighting a need for improved follow up post-RT for bone metastases. Staffing challenges for this intervention must be overcome.

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疼痛性骨转移姑息放射治疗后患者的前瞻性监测：一项可行性研究。

背景：骨转移是癌症相关疼痛最常见的原因。放射治疗（RT）可成功缓解疼痛，但目前尚未就姑息性放射治疗后的监测达成共识。本研究旨在评估放疗后监测疼痛性骨转移的可行性：研究在一家学术癌症中心进行。衡量患者可行性的指标包括接听电话的百分比、招募难易程度和研究保留率。临床医生的衡量标准包括 3 天内接听电话的百分比、通话时间和定性反馈。患者被确定为疼痛性骨转移瘤，并接受了 RT 治疗。骨转移瘤的最严重疼痛评分至少为 4 分（0-10 分制），疼痛部位为放射学证实的病灶。在 RT 治疗后的第 1 周、第 4 周和第 8 周召集患者。对疼痛反应和阿片类药物使用情况进行评估。生活质量通过有效问卷进行评估。使用描述性统计来评估患者和临床医生在 RT 术后 8 周内是否达到了这些指标：20名患者获得同意：14名参与者完成了治疗，且在第1周前未住院或死亡。患者中50%为男性，50%为女性。招募工作迅速完成，没有患者退出。第 1 周的回复率为 85%，第 4 周为 83%，第 8 周为 83%。有 6 名患者被转诊回其医疗机构接受疼痛治疗。3 天内与患者通话的比例中位数为 63%（范围为 40-82%），通话时间中位数为 16 分钟（范围为 8-42）。需要翻译的患者通话时间更长。护士的反馈意见强调了通话时间和护理时间的局限性：结论：所有患者的可行性都得到了满足。有六名患者需要进一步的疼痛治疗，这表明有必要改善骨转移 RT 术后的随访。必须克服这一干预措施在人员配备方面的挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of palliative medicine Medicine-Anesthesiology and Pain Medicine

自引率

0.00%

发文量

231

期刊介绍： Annals of Palliative Medicine (Ann Palliat Med; Print ISSN 2224-5820; Online ISSN 2224-5839) is an open access, international, peer-reviewed journal published quarterly with both online and printed copies since 2012. The aim of the journal is to provide up-to-date and cutting-edge information and professional support for health care providers in palliative medicine disciplines to improve the quality of life for patients and their families and caregivers.