ESTRO 2024 - Abstract Book

S1920

Clinical - Mixed sites, palliation

ESTRO 2024

Material/Methods:

Data on gender, age, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), RT objectives, primary cancer, and tumor stage were collected in 13 Italian RT departments. A Pain Score was assigned on a scale from 0 (no pain; Numeric Rating Scale (NRS): 0) to 3 (severe pain; NRS: 7-10). An Analgesic Score was determined on a scale from 0 (no pain medication) to 3 (use of strong opioids). The PMI was calculated by subtracting the pain score from the analgesic score, with negative values indicating inadequate pain management.

Results:

Out of 456 patients, 21.7% reported NMP. Among them, 71.5% had a PMI value <0, indicating inadequate pain management. The risk of PMI <0 was significantly higher in NMP compared to cancer-related pain (odds ratio: 2.630; 95% confidence interval: 1.879-3.683; p<0.001). Patients were referred for curative and palliative RT in 91.2% and 8.8% of cases, respectively. Patients undergoing curative RT and palliative RT showed PMI <0 in 72.3% and 62.5% of cases, respectively. Additionally, patients with non-metastatic disease and those with metastases had PMI <0 in 72.5% and 64.4% of cases, respectively. Specifically: i) all patients with mild NMP (Numeric Rating Scale, NRS: 1-4) were not using analgesics; ii) 38.3% of patients with moderate NMP (NRS: 5-6) were not using analgesics, and 61.7% were taking non-opioid medications; iii) 33.3% of patients with severe NMP (NRS: 7-10) were not using analgesics, 54.5% were taking non-opioid analgesics, and only 12.2% were using opioid medications. Parameters significantly correlated with NMP and PMI <0 included female gender, better ECOG-PS score (ECOG-PS=1), and breast cancer.

Conclusion:

This analysis highlights a substantial prevalence of NMP in cancer patients, with inadequate pain management in most cases. It underscores the need for a more patient-centered approach, suggesting that physicians often pay limited attention to non-cancer-related symptoms in cancer patients.

Keywords: Non-malignant pain, cancer patients

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Costanza Maria Donati 1,2 , Elena Nardi 3 , Alice Zamagni 1 , Giambattista Siepe 2 , Francesco Cellini 4,5 , Alessia Di Rito 6 , Maurizio Portaluri 7 , Anna Santacantarina 8 , Rossella Di Franco 9 , Salvatore Parisi 10 , Vincenzo Fusco 11 , Anonella Bianculli 11 , Pierpaolo Ziccarelli 12 , Luigi Ziccarelli 12 , Domenico Genovesi 13 , Luciana Caravatta 13 , Francesco Deodato 5,14 , Gabriella Macchia 14 , Francesco Fiorica 15 , Milly Buwenge 1 , Romina Rossi 16 , Silvia Cammelli 1,2 , Marco Maltoni 1,17 , Alessio Giuseppe Morganti 1,2