ESTRO 2025 - Abstract Book

S1487

Clinical – Mixed sites & palliation

ESTRO 2025

References: [1] Gerard, I. J., Bernier, M. L., Hijal, T., Kopek, N., Pater, P., Stroian, G., & Alfieri, J. (2022). Stereotactic Arrhythmia Radioablation for Ventricular Tachycardia (StAR-VT): A Single Institution, Dose De-Escalation, Phase II Trial. International Journal of Radiation Oncology, Biology, Physics, 114(3), e416-e417.

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Poster Discussion Pain management adequacy in patients with bone metastases: a secondary analysis from the prospective PRAIS trial Savino Cilla 1 , Romina Rossi 2,3 , Costanza M Donati 3,4 , Ragnhild Habberstad 5,6 , Pal Klepstad 7,8 , Monia Dall'Agata 9 , Vanessa Valenti 10 , Stein Kassa 11 , Erika Galietta 3,4 , Arina A Zamfir 3 , Federica Medici 4,12 , Rebecca Sassi 13 , Alberto Bazzocchi 13 , Mira Huhtala 14 , Martijn Boomsma 15 , Alessandro Napoli 16 , Silvia Cammelli 3 , Alessio G Morganti 3,4 , Marco C Maltoni 4 1 Medical Physics Unit, Responsible Research Hospital, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, Campobasso, Italy. 2 Palliative Care Unit, AUSL Romagna, Forlì, Italy. 3 Radiation Oncology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy. 4 Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy. 5 Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Thondheim, Norway. 6 Department of Oncology, St. Olavs University Hospital, Thondheim, Norway. 7 Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Thondheim, Norway. 8 Department of Anesthesiology and Intensive Care Medicine, St. Olavs University Hospital, Thondheim, Norway. 9 Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Forlì-Cesena, Italy. 10 Palliative Care, Pain Therapy and Rehabilitation Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Forlì-Cesena, Italy. 11 Department of Oncology, Oslo University Hospital, Oslo, Norway. 12 Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy. 13 Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoliersitaria di Bologna, Bologna, Italy. 14 Department of Oncology, Turku University Hospital, Turku, Finland. 15 Department of Radiology, Hospital, Dokter van Heesweg 2, Zwolle, Netherlands. 16 Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy Purpose/Objective: Pain management in cancer patients, particularly those with bone metastases (BMs), is crucial for improving quality of life (QoL). However, inadequate pain control remains a significant issue, especially in patients undergoing palliative radiotherapy (RT). This study, a sub-analysis of the PRAIS trial, aimed to evaluate the adequacy of pain management among patients receiving palliative RT for painful BMs and identify predictors of effective pain management. Material/Methods: This multicenter, observational sub-analysis included 560 patients with radiologically confirmed BMs undergoing palliative RT across European centers. Pre-treatment assessments captured demographic, clinical, and pain-related data, including pain intensity (Numeric Rating Scale, NRS) and analgesic usage, with the Pain Management Index (PMI) used to evaluate adequacy. Predictors of pain management effectiveness were analyzed using the Least Absolute Shrinkage and Selection Operator (LASSO) and Classification and Regression Tree (CART) models, validated through cross-validation and receiver operator characteristic (ROC) analysis. Statistical significance was set at p < 0.05. Results: The mean age of participants was 66 years (SD ± 10.7), with males comprising 61.6%. BMs were most frequently located in the spine (46%) and pelvis (33%). Among the cohort, 81% used opioids, and 19% experienced inadequate pain management (PMI < 0). Predictors of inadequate management included higher Karnofsky Performance Status (KPS ≥ 90, 59.3% adequacy vs. 85.0% for KPS < 90), outpatient care settings (81.1% adequacy vs. 93.4% for inpatient or other care), pelvic treatment sites (89.5% adequacy vs. 95.7% for other sites), and primary cancer type. Lung