Prevalence and characterization of breakthrough pain in cancer patients with proctalgia treated with 3D pelvic radiotherapy

Purpose Radiotherapy-induced dysfunction of the gastrointestinal tract is common in cancer patients and has a significant impact on their quality of life. In this study, we investigated the prevalence of breakthrough cancer pain (BTcP) in patients undergoing 3D pelvic radiotherapy and who had procta...

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Bibliographic Details
Published in:	Clinical & translational oncology Vol. 21; no. 12; pp. 1707 - 1711
Main Authors:	Ferrero, V. T., Oset, M. M., Masferrer, J. P., Pardo, E. H., Sorolla, E. J., Largo, S. C.
Format:	Journal Article
Language:	English
Published:	Cham Springer International Publishing 01-12-2019
Subjects:	Adult Aged Aged, 80 and over Anus Neoplasms - drug therapy Anus Neoplasms - radiotherapy Breakthrough Pain - drug therapy Breakthrough Pain - epidemiology Breakthrough Pain - etiology Cancer Pain - drug therapy Cancer Pain - epidemiology Cancer Pain - etiology Chi-Square Distribution Cross-Sectional Studies Endometrial Neoplasms - radiotherapy Female Humans Male Medicine Medicine & Public Health Middle Aged Neoplasms - drug therapy Neoplasms - radiotherapy Oncology Pain - drug therapy Pain - epidemiology Prevalence Prostatic Neoplasms - drug therapy Prostatic Neoplasms - radiotherapy Radiotherapy Dosage Radiotherapy, Conformal - adverse effects Rectal Diseases - drug therapy Rectal Diseases - epidemiology Rectal Neoplasms - drug therapy Rectal Neoplasms - radiotherapy Research Article Spain - epidemiology Urinary Bladder Neoplasms - drug therapy Urinary Bladder Neoplasms - radiotherapy Uterine Cervical Neoplasms - radiotherapy Spain Breakthrough pain Proctalgia Pelvic 3D radiotherapy
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Summary:	Purpose Radiotherapy-induced dysfunction of the gastrointestinal tract is common in cancer patients and has a significant impact on their quality of life. In this study, we investigated the prevalence of breakthrough cancer pain (BTcP) in patients undergoing 3D pelvic radiotherapy and who had proctalgia. Methods This observational, multicenter, cross-sectional epidemiological study was performed in 13 Spanish hospitals. Data were obtained on the presence and characteristics of BTcP, demographics, common comorbidities, and treatments prescribed to the patients. Results The prevalence of BTcP in patients undergoing pelvic 3D external radiotherapy with proctalgia ( N = 105) was 48.6% (95% CI 39.0–58.1%). BTcP was further characterized in 59 patients. The mean (± SD) intensity of the BTcP episodes was 7.45 ± 1.47 in a visual analog scale. We found several statistically significant associations between the descriptive variables of BTcP with demographic and clinical variables associated with the tumor or the patient, such as an increased number of BTcP episodes per day depending on the presence or absence of diabetes ( p = 0.001, Chi-square) or time to the onset of pain relief depending on the location of the tumor ( p = 0.019, Chi-square). Fentanyl was the drug of choice in BTcP episodes for 95% of the patients. Conclusions This study demonstrated a high prevalence of BTcP prevalence in cancer patients undergoing pelvic 3D radiotherapy and with proctalgia. Although the variables determining the onset of BTcP are still unclear, our results could help in the design of future clinical studies addressing the treatment of BTcP in these patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Undefined-2
ISSN:	1699-048X 1699-3055
DOI:	10.1007/s12094-019-02102-1