{"title":"Quality of Life Report Associated with Pain Response and Patient Classification System for Palliative Radiotherapy: A prospective observational study.","authors":"Yutaro Koide, Yurika Shindo, Masamune Noguchi, Tomoki Kitagawa, Takahiro Aoyama, Hidetoshi Shimizu, Shingo Hashimoto, Hiroyuki Tachibana, Takeshi Kodaira","doi":"10.1016/j.ijrobp.2024.11.102","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>A novel classification system has been proposed to stratify patients undergoing palliative radiotherapy based on their pain response and time to progression. This study used prospective observational data to quantify quality-of-life (QoL) changes associated with pain response and the classification system.</p><p><strong>Methods and materials: </strong>Between August 2021 and September 2022, 366 painful lesions with an NRS of 2 or more from the 261 eligible patients underwent palliative radiotherapy. Patients were followed up prospectively at 2, 4, 12, 24, 36, and 52 weeks post-radiotherapy, with EORTC QLQ-C15-PAL and QLQ-BM22 questionnaires obtained simultaneously with pain response assessments. The primary endpoint was defined as the global health status (GHS/QoL) improvements at 12 weeks based on minimally clinically important differences and compared by the pain response (responders vs. non-responders) and by class 1 (no opioids, no re-irradiation, n = 89), 2 (neither class 1 nor 3, n = 211), and 3 (opioids and re-irradiation, n = 66).</p><p><strong>Results: </strong>With a median follow-up time of 21 weeks for pain response and 13 weeks for QoL assessment, 1773 pairs of QLQ-C15-PAL and QLQ-BM22 questionnaires were collected. The QoL assessment at baseline was covered with 97% (355/366) of lesions and 67% (183/273) at 12 weeks: this compliance was lower in non-responders than in responders (57% vs. 72%, p=.004) and highest in class 1, followed by classes 2 and 3 (70% vs. 44% vs. 39%, p=.001). The improvement rate was significantly different by class, with class 3 having the lowest in all subscales except nausea and psychosocial aspects: the improvement rate of GHS/QoL was 33% in class 1, 31% in class 2, and 20% in class 3, p=.001).</p><p><strong>Conclusions: </strong>The QoL changes associated with pain response and the classification system were identified, suggesting that the classification system may help identify populations more or less likely to improve QoL, in addition to separating pain response rates.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4000,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Radiation Oncology Biology Physics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ijrobp.2024.11.102","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：有人提出了一种新的分类系统，根据疼痛反应和病情进展时间对接受姑息放疗的患者进行分层。本研究使用前瞻性观察数据量化与疼痛反应和分类系统相关的生活质量（QoL）变化：2021年8月至2022年9月期间，261名符合条件的患者中NRS大于或等于2的366名疼痛病灶患者接受了姑息性放疗。在放疗后2、4、12、24、36和52周对患者进行前瞻性随访，在进行疼痛反应评估的同时进行EORTC QLQ-C15-PAL和QLQ-BM22问卷调查。主要终点是根据最小临床重要性差异定义的12周时总体健康状况（GHS/QoL）改善情况，并按疼痛反应（有反应者与无反应者）和1级（无阿片类药物、无再照射，n=89）、2级（既非1级也非3级，n=211）和3级（阿片类药物和再照射，n=66）进行比较：疼痛反应的中位随访时间为 21 周，QoL 评估的中位随访时间为 13 周，共收集了 1773 对 QLQ-C15-PAL 和 QLQ-BM22 问卷。基线QoL评估覆盖了97%（355/366）的病灶，12周时覆盖了67%（183/273）的病灶：未应答者的应答率低于应答者（57% vs. 72%，p=.004），1级应答率最高，其次是2级和3级（70% vs. 44% vs. 39%，p=.001）。不同级别的改善率存在明显差异，除恶心和社会心理方面外，3级在所有分量表中的改善率最低：1级的GHS/QoL改善率为33%，2级为31%，3级为20%，p=.001）：研究确定了与疼痛反应和分级系统相关的 QoL 变化，这表明除了区分疼痛反应率外，分级系统还有助于确定 QoL 改善可能性高或低的人群。
Quality of Life Report Associated with Pain Response and Patient Classification System for Palliative Radiotherapy: A prospective observational study.
Purpose: A novel classification system has been proposed to stratify patients undergoing palliative radiotherapy based on their pain response and time to progression. This study used prospective observational data to quantify quality-of-life (QoL) changes associated with pain response and the classification system.
Methods and materials: Between August 2021 and September 2022, 366 painful lesions with an NRS of 2 or more from the 261 eligible patients underwent palliative radiotherapy. Patients were followed up prospectively at 2, 4, 12, 24, 36, and 52 weeks post-radiotherapy, with EORTC QLQ-C15-PAL and QLQ-BM22 questionnaires obtained simultaneously with pain response assessments. The primary endpoint was defined as the global health status (GHS/QoL) improvements at 12 weeks based on minimally clinically important differences and compared by the pain response (responders vs. non-responders) and by class 1 (no opioids, no re-irradiation, n = 89), 2 (neither class 1 nor 3, n = 211), and 3 (opioids and re-irradiation, n = 66).
Results: With a median follow-up time of 21 weeks for pain response and 13 weeks for QoL assessment, 1773 pairs of QLQ-C15-PAL and QLQ-BM22 questionnaires were collected. The QoL assessment at baseline was covered with 97% (355/366) of lesions and 67% (183/273) at 12 weeks: this compliance was lower in non-responders than in responders (57% vs. 72%, p=.004) and highest in class 1, followed by classes 2 and 3 (70% vs. 44% vs. 39%, p=.001). The improvement rate was significantly different by class, with class 3 having the lowest in all subscales except nausea and psychosocial aspects: the improvement rate of GHS/QoL was 33% in class 1, 31% in class 2, and 20% in class 3, p=.001).
Conclusions: The QoL changes associated with pain response and the classification system were identified, suggesting that the classification system may help identify populations more or less likely to improve QoL, in addition to separating pain response rates.
期刊介绍：
International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field.
This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.
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