ESTRO 2025 - Abstract Book

S1456

Clinical – Mixed sites & palliation

ESTRO 2025

33

Digital Poster A prospective study on Quality of Life associated with pain response and patient classification system for palliative radiotherapy Yutaro Koide, Yurika Shindo, Masamune Noguchi, Tomoki Kitagawa, Takahiro Aoyama, Hidetoshi Shimizu, Shingo Hashimoto, Hiroyuki Tachibana, Takeshi Kodaira Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan Purpose/Objective: A novel classification system has been proposed to stratify patients undergoing palliative radiotherapy based on their pain response and time to progression [1]. This study used prospective observational data to quantify quality of-life (QoL) changes associated with pain response and the classification system. Material/Methods: 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). Conclusion: 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.

Keywords: Quality of Life, palliative radiotherapy

References: [1] Koide Y, Shindo Y, Nagai N, Kitagawa T, Aoyama T, Shimizu H, et al. Classification of patients with painful tumors to predict response to palliative radiation therapy. Int J Radiat Oncol Biol Phys 2024;120:79 – 88.