ESTRO 2023 - Abstract Book

S39

Saturday 13 May

ESTRO 2023

C.M. Donati 1 , E. Nardi 2 , A. Zamagni 1 , G. Siepe 3 , F. Cellini 4 , A. Di Rito 5 , M. Portaluri 6 , C. De Tommaso 7 , A. Santacaterina 8 , C. Tamburella 8 , R. Di Franco 9 , S. Parisi 10 , S. Cossa 10 , V. Fusco 11 , A. Bianculli 11 , P. Ziccarelli 12 , L. Ziccarelli 12 , D. Genovesi 13 , L. Caravatta 13 , F. Deodato 14 , G. Macchia 14 , F. Fiorica 15 , G. Napoli 15 , M. Buwenge 16 , R. Rossi 17 , S. Cammelli 1 , M. Maltoni 18 , A.G. Morganti 1 1 Radiation Oncology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 2 Medical Statistics, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy; 3 Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 4 Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Università Cattolica del Sacro Cuore, Dipartimento Universitario Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy. Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy; 5 IRCCS Istituto Tumori, "Giovanni Paolo II", , Bari, Italy; 6 IRCCS Istituto Tumori, "Giovanni Paolo II", Bari, Italy; 7 General Hospital, "Perrino", Brindisi, Italy; 8 U.O. di Radioterapia , AOOR PAPARDO PIEMONTE, Messina, Italy; 9 S.C. di Radioterapia , dell’Istituto Nazionale Tumori Pascale, Napoli, Italy; 10 Radioterapia Opera di S. Pio da Pietralcina, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; 11 IRCCS, CROB, Rionero in Vulture, Italy; 12 U.O. Radioterapia Oncologica, S.O. Mariano Santo, Cosenza, Italy; 13 Radioterapia, Università degli Studi G. D’Annunzio, Chieti, Italy; 14 Radiotherapy Unit, Gemelli Molise Hospital, Catholic University of Sacred Heart, Campobasso, Italy; 15 U.O.C.di Radioterapia e Medicina Nucleare, Ospedale Mater Salutis di Legnago, Verona, Italy; 16 Radiation Oncology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy; 17 IRCCS , Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy; 18 Medical Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy Purpose or Objective Pain is one of the most common symptoms among cancer patients, occurring in 30-50% of patients undergoing active antineoplastic therapy and in 75-90% of patients with advanced stage tumor. Furthermore, studies on pain assessment during radiotherapy (RT) are lacking. The aim of this multicenter observational prospective trial was to evaluate the prevalence of pain in RT departments using the Numeric Rating Score (NRS). Moreover, we analyzed the correlation between pain intensity and classes of used analgesic drugs. Materials and Methods In this study we enrolled 2104 patients from 13 RT Departments. RT aims and patients and pain characteristics were recorded, using a data collection sheet, during patients visits (in the course or at the end of treatment). The Pain Score was graded from 0 (no pain; NRS: 0) to 3 (severe pain; NRS: 7-10). An Analgesic Score was defined with values between 0 (no pain medication) and 3 (use of strong opioids). This study was approved by the Ethical Committee of the participating centers (ARISE-1 study). Results Of enrolled patients, 1417 had pain or were under analgesic treatment. Among them, 53.8% complained of intermediate to severe pain. The incidence of intermediate/severe pain was found to increase progressively from patients not taking analgesic drugs, to those taking non-opioid drugs, to those taking weak opioid drugs, showing a clearly lower willingness to prescribe drugs of a higher class as the same increased (30%, 46%, and 83%, respectively; p<0.001; Figure 1). Moreover, patients under strong opioids reported moderate/severe pain in 75% of cases.

Conclusion This analysis shows persistent barriers to the use of strong opioid even in cancer patients. Furthermore, our study shows the high incidence of moderate to severe pain in patients receiving opioid drugs. The frequent ineffectiveness of opioid therapy in this setting, probably, at least in part, due to suboptimal doses or posology. Therefore, further efforts are needed to improve pain management, particularly in the RT settings. In particular, both training in pain therapy for radiation oncologists and closer multidisciplinary collaboration are needed for this purpose.