Abstract
Objectives: To explore the effect of breakthrough cancer pain (BTcP) treatment on quality of sleep and other aspects of the health-related quality of life (HRQoL) in patients with cancer pain. Methods: In an observational, multicenter, cohort study, cancer patients from palliative care units, oncology departments, and pain clinics and affected by BTcP were included. Enrolled patients were assessed at the four visits: T0 (baseline), T7, T14, and T28. Stable chronic background pain (numeric rating scale, NRS ≤ 4) during the whole study period was mandatory. BTcP was treated through transmucosal fentanyl. Three questionnaires were used to measure the HRQoL: EORTC QLQ-C15-PAL, Pittsburgh Sleep Quality Index (PSQI), and the Edmonton Symptom Assessment System (ESAS). RESULTS: In 154 patients, the HRQoL showed a significant improvement for all physical and emotional characteristics in the EORTC QLQ-C15-PAL, except for nausea and vomiting (linear p-value = 0.1) and dyspnea (Linear p-value = 0.05). The ESAS and PSQI questionnaires confirmed these positive results (p < 0.0001 and p = 0.002, respectively). Conclusions: This prospective investigation by an Italian expert group, has confirmed that careful management of BTcP induces a paramount improvement on the HRQoL. Because in cancer patients there is a high prevalence of BTcP and this severe acute pain has deleterious consequences, this information can have an important clinical significance.
Highlights
Pain is one of the most frequent symptoms in cancer patients as it occurs in 20–30% of cases during the initial stages and in up to 75% of patients in advanced disease
This study explored the effect of breakthrough cancer pain (BTcP) treatment on several aspects of the health-related quality of life (HRQoL) in patients with cancer pain
Despite there is a debate on the starting dose of rapid-onset opioids (ROOs), i.e., if a titration dose is needed or these drugs must be administered in proportional to the regimen of opioid for background pain treatment [16], in this study we have adopted the ROOs administration strategy based on the following the provisions of the relative summary of product characteristics, and in absence of specific contraindications
Summary
Pain is one of the most frequent symptoms in cancer patients as it occurs in 20–30% of cases during the initial stages and in up to 75% of patients in advanced disease. Concerning pain intensity, moderate to severe pain can affect up to 40% of all patients. This symptom strongly affects the patient’s health-related quality of life (HRQoL) and daily activities throughout the cancer disease [1]. In this clinical setting, it is mandatory to relieve pain and other symptoms and to improve the HRQoL at any stage of the disease [2]. Significant results with largest effect size were observed for Global health status/QoL, pain and ESAS (η2p = 0.14; 0.26 and 0.14, respectively)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
