An investigation into the incidence of pain flare in patients undergoing radiotherapy for symptomatic bone metastases

Goldfinch, Rebecca and White, Nick (2018) An investigation into the incidence of pain flare in patients undergoing radiotherapy for symptomatic bone metastases. Radiography. ISSN 10788174

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Abstract

Introduction
External Beam Radiotherapy (EBRT) is a recognised intervention for symptomatic pain relief from bone metastases. Pain flare is a reported EBRT toxicity, described in 16-41% of steroid-naïve patients. This study aimed to determine incidence and duration of pain flare amongst patients within one Oncology Centre.

Methods
Patients receiving EBRT for bone metastases were recruited to a prospective cohort study. Baseline pain scores and a daily pain/analgesia diary were recorded during EBRT and for 14days thereafter. Pain flare was defined as a two-point increase on a pain scale or 25% increase in analgesia intake, with a return to baseline.

Results
Of the thirty-two participants, 69% (n=22) completed the diary. 41% (n=9) patients experienced pain flare, the median duration being 3 days. Of the evaluable patients, 55% (n=12) were male, 45% (n=9) female. The median age was 73years, (range 40-83). The common primary sites of disease were Breast (32%) and Prostate (32%), with other sites making up the remaining 36%. The most frequent EBRT site was the spine (63%), with other treatment sites including pelvis (23%) and extremities (14%). EBRT regimes were restricted to 20Gy in 5 treatments, received by 32% (n=7) of patients and 8Gy in 1 treatment (68% (n=14)). Of these two regimes, pain flare was reported by 29% and 47% respectively.

Conclusion
Pain flare is a common toxicity of EBRT for bone metastases. Taking the small sample size into consideration, the incidence and duration of pain flare in patients within this single-centre study are comparable with those found in international studies.

Key Words

Item Type:	Article
Identification Number:	10.1016/j.radi.2018.01.010
Dates:	Date Event 2 February 2018 Accepted 21 February 2018 Published Online
Subjects:	CAH02 - subjects allied to medicine > CAH02-05 - medical sciences > CAH02-05-01 - medical technology CAH01 - medicine and dentistry > CAH01-01 - medicine and dentistry > CAH01-01-01 - medical sciences (non-specific)
Divisions:	Faculty of Health, Education and Life Sciences > Centre for Social Care, Health and Related Research (C-SHARR) Faculty of Health, Education and Life Sciences > College of Health and Care Professions
Depositing User:	Nick White
Date Deposited:	12 Jun 2018 07:22
Last Modified:	03 Mar 2022 17:15
URI:	https://www.open-access.bcu.ac.uk/id/eprint/6026

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