ESTRO 2024 - Abstract Book

S1921

Clinical - Mixed sites, palliation

ESTRO 2024

1 Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy. 2 Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 3 Medical Statistics, Alma Mater Studiorum University of Bologna, Bologna, Italy. 4 Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Roma, Italy. 5 Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, 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 Radiation Oncology 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 IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST), "Dino Amadori", Meldola, Italy. 17 Medical Oncology Unit, IRCCS Azienda Ospedaliero Universitatia di Bologna, Bologna, Italy

Purpose/Objective:

Pain is a pervasive symptom among cancer patients, affecting 75-90% of those with advanced tumors. Radiotherapy (RT) stands as an effective treatment option in this context. However, there is a lack of evidence regarding the referral patterns for RT in symptomatic patients. Consequently, this subanalysis of our prospective observational multicenter study (ARISE-1) aimed to assess the adequacy and effectiveness of analgesic therapy in patients referred for palliative RT.

Material/Methods:

This analysis incorporated 534 patients experiencing pain from 13 Italian RT Departments. During their initial visit, we recorded RT objectives, patient profiles, and pain characteristics using a structured data collection sheet. A Pain Score was established with values ranging from 0 (no pain; Numeric Rating Scale (NRS): 0) to 3 (severe pain; NRS: 7 10). An Analgesic Score was assigned on a scale from 0 (no pain medication) to 3 (use of strong opioids). To evaluate the adequacy of pain management, we employed the Pain Management Index (PMI), calculated by subtracting the Pain Score from the Analgesic Score. A PMI score less than 0 indicates patients with inadequate analgesic therapy.

Results:

Patients reported various types of pain, including cancer-related pain (71.2%), non-cancer pain (6.0%), and mixed pain (22.8%). A subset of patients (15.0%) was not receiving any analgesic therapy, while 34.0% were using non opioid drugs. Additionally, 51% of patients were prescribed weak or strong opioids. PMI values below 0 were observed in 28.0% of cases. Notably, most patients with PMI values greater than or equal to 0 reported moderate to severe pain. In summary, only 33% of patients received adequate and effective therapy (see Table 1).