Objective: 80% of patients with advanced cancer suffer from chronic pain and 40-80% of these suffer from breakthrough cancer pain (BTcP). In this setting, palliative radiotherapy (RT) plays an important role in cancer pain management. On the other hand, the so called procedural pain (PP), due to the positioning during RT, could compromise patients’ quality of life and the therapeutic procedure itself.
Patients and Methods: From April to June 2014, 130 patients (66% treated with curative purposes, 34% for palliative purposes) were enrolled for a daily survey about the pain perception and relative analgesic therapy.
Results: 99.2% of patients completed treatment. PP was referred in 18% of patients during CT-simulations (CTS), and in the 18.5% at the first session of RT. The reduction of incidence of procedural pain was accompanied by a reduced intensity of pain: from mean NRS 9 at CTS time to mean NRS 5 at last session. Analgesic therapy was modified especially in the initial phases of radiation treatment; at final evaluation, 59% of patients received pain therapy at fixed times (21% opioid) and 25% at request (18% using ROOs).
Conclusions: Management of cancer related pain during RT plays a fundamental role in palliation for metastatic patients. Radiation oncologist has to correctly assess cancer pain, first of all the procedural one, in order to improve patients’ compliance to treatment and quality of life.