Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer

M. Di Maio, C. Gridelli, C. Gallo, L. Manzione, L. Brancaccio, S. Barbera, S. F. Robbiati, G. P. Ianniello, F. Ferraù, E. Piazza, L. Frontini, F. Rosetti, F. Carrozza, A. Bearz, M. Spatafora, V. Adamo, L. Isa, R. V. Iaffaioli, E. Di Salvo, F. Perrone

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

Pain is a highly distressing symptom for patients with advanced cancer. WHO analgesic ladder is widely accepted as a guideline for its treatment. Our aim was to describe pain prevalence among patients diagnosed with advanced non-small-cell lung cancer (NSCLC), impact of pain on quality of life (QoL) and adequacy of pain management. Data of 1021 Italian patients enrolled in three randomised trials of chemotherapy for NSCLC were pooled. QoL was assessed by EORTC QLQ-C30 and LC-13. Analgesic consumption during the 3 weeks following QoL assessment was recorded. Adequacy of pain management was evaluated by the Pain Management Index (PMI). Some pain was reported by 74% of patients (42% mild, 24% moderate and 7% severe); 50% stated pain was affecting daily activities (30% a little, 16% quite a bit, 336 very much). Bone metastases strongly affected presence of pain. Mean global QoL linearly decreased from 64.9 to 36.4 from patients without pain to those with severe pain (P <0.001). According to PMI, 616 out of 752 patients reporting pain (82%) received inadequate analgesic treatment. Bone metastases were associated with improved adequacy and worst pain with reduced adequacy at multivariate analysis. In conclusion, pain is common in patients with advanced NSCLC, significantly affects QoL, and is frequently undertreated. We recommend that: (i) pain self-assessment should be part of oncological clinical practice; (ii) pain control should be a primary goal in clinical practice and in clinical trials; (iii) physicians should receive more training in pain management; (iv) analgesic treatment deserves greater attention in protocols of anticancer treatment.

Original languageEnglish
Pages (from-to)2288-2296
Number of pages9
JournalBritish Journal of Cancer
Volume90
Issue number12
Publication statusPublished - Jun 14 2004

Fingerprint

Pain Management
Non-Small Cell Lung Carcinoma
Pain
Quality of Life
Analgesics
Neoplasm Metastasis
Bone and Bones
Pain Measurement
Clinical Protocols
Therapeutics
Multivariate Analysis
Clinical Trials
Guidelines
Physicians
Drug Therapy

Keywords

  • Analgesics
  • Cancer pain
  • Lung cancer
  • Pain Management Index

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Di Maio, M., Gridelli, C., Gallo, C., Manzione, L., Brancaccio, L., Barbera, S., ... Perrone, F. (2004). Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer. British Journal of Cancer, 90(12), 2288-2296.

Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer. / Di Maio, M.; Gridelli, C.; Gallo, C.; Manzione, L.; Brancaccio, L.; Barbera, S.; Robbiati, S. F.; Ianniello, G. P.; Ferraù, F.; Piazza, E.; Frontini, L.; Rosetti, F.; Carrozza, F.; Bearz, A.; Spatafora, M.; Adamo, V.; Isa, L.; Iaffaioli, R. V.; Di Salvo, E.; Perrone, F.

In: British Journal of Cancer, Vol. 90, No. 12, 14.06.2004, p. 2288-2296.

Research output: Contribution to journalArticle

Di Maio, M, Gridelli, C, Gallo, C, Manzione, L, Brancaccio, L, Barbera, S, Robbiati, SF, Ianniello, GP, Ferraù, F, Piazza, E, Frontini, L, Rosetti, F, Carrozza, F, Bearz, A, Spatafora, M, Adamo, V, Isa, L, Iaffaioli, RV, Di Salvo, E & Perrone, F 2004, 'Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer', British Journal of Cancer, vol. 90, no. 12, pp. 2288-2296.
Di Maio M, Gridelli C, Gallo C, Manzione L, Brancaccio L, Barbera S et al. Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer. British Journal of Cancer. 2004 Jun 14;90(12):2288-2296.
Di Maio, M. ; Gridelli, C. ; Gallo, C. ; Manzione, L. ; Brancaccio, L. ; Barbera, S. ; Robbiati, S. F. ; Ianniello, G. P. ; Ferraù, F. ; Piazza, E. ; Frontini, L. ; Rosetti, F. ; Carrozza, F. ; Bearz, A. ; Spatafora, M. ; Adamo, V. ; Isa, L. ; Iaffaioli, R. V. ; Di Salvo, E. ; Perrone, F. / Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer. In: British Journal of Cancer. 2004 ; Vol. 90, No. 12. pp. 2288-2296.
@article{18257720da454040832d8b0f745bcb1d,
title = "Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer",
abstract = "Pain is a highly distressing symptom for patients with advanced cancer. WHO analgesic ladder is widely accepted as a guideline for its treatment. Our aim was to describe pain prevalence among patients diagnosed with advanced non-small-cell lung cancer (NSCLC), impact of pain on quality of life (QoL) and adequacy of pain management. Data of 1021 Italian patients enrolled in three randomised trials of chemotherapy for NSCLC were pooled. QoL was assessed by EORTC QLQ-C30 and LC-13. Analgesic consumption during the 3 weeks following QoL assessment was recorded. Adequacy of pain management was evaluated by the Pain Management Index (PMI). Some pain was reported by 74{\%} of patients (42{\%} mild, 24{\%} moderate and 7{\%} severe); 50{\%} stated pain was affecting daily activities (30{\%} a little, 16{\%} quite a bit, 336 very much). Bone metastases strongly affected presence of pain. Mean global QoL linearly decreased from 64.9 to 36.4 from patients without pain to those with severe pain (P <0.001). According to PMI, 616 out of 752 patients reporting pain (82{\%}) received inadequate analgesic treatment. Bone metastases were associated with improved adequacy and worst pain with reduced adequacy at multivariate analysis. In conclusion, pain is common in patients with advanced NSCLC, significantly affects QoL, and is frequently undertreated. We recommend that: (i) pain self-assessment should be part of oncological clinical practice; (ii) pain control should be a primary goal in clinical practice and in clinical trials; (iii) physicians should receive more training in pain management; (iv) analgesic treatment deserves greater attention in protocols of anticancer treatment.",
keywords = "Analgesics, Cancer pain, Lung cancer, Pain Management Index",
author = "{Di Maio}, M. and C. Gridelli and C. Gallo and L. Manzione and L. Brancaccio and S. Barbera and Robbiati, {S. F.} and Ianniello, {G. P.} and F. Ferra{\`u} and E. Piazza and L. Frontini and F. Rosetti and F. Carrozza and A. Bearz and M. Spatafora and V. Adamo and L. Isa and Iaffaioli, {R. V.} and {Di Salvo}, E. and F. Perrone",
year = "2004",
month = "6",
day = "14",
language = "English",
volume = "90",
pages = "2288--2296",
journal = "British Journal of Cancer",
issn = "0007-0920",
publisher = "Nature Publishing Group",
number = "12",

}

TY - JOUR

T1 - Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer

AU - Di Maio, M.

AU - Gridelli, C.

AU - Gallo, C.

AU - Manzione, L.

AU - Brancaccio, L.

AU - Barbera, S.

AU - Robbiati, S. F.

AU - Ianniello, G. P.

AU - Ferraù, F.

AU - Piazza, E.

AU - Frontini, L.

AU - Rosetti, F.

AU - Carrozza, F.

AU - Bearz, A.

AU - Spatafora, M.

AU - Adamo, V.

AU - Isa, L.

AU - Iaffaioli, R. V.

AU - Di Salvo, E.

AU - Perrone, F.

PY - 2004/6/14

Y1 - 2004/6/14

N2 - Pain is a highly distressing symptom for patients with advanced cancer. WHO analgesic ladder is widely accepted as a guideline for its treatment. Our aim was to describe pain prevalence among patients diagnosed with advanced non-small-cell lung cancer (NSCLC), impact of pain on quality of life (QoL) and adequacy of pain management. Data of 1021 Italian patients enrolled in three randomised trials of chemotherapy for NSCLC were pooled. QoL was assessed by EORTC QLQ-C30 and LC-13. Analgesic consumption during the 3 weeks following QoL assessment was recorded. Adequacy of pain management was evaluated by the Pain Management Index (PMI). Some pain was reported by 74% of patients (42% mild, 24% moderate and 7% severe); 50% stated pain was affecting daily activities (30% a little, 16% quite a bit, 336 very much). Bone metastases strongly affected presence of pain. Mean global QoL linearly decreased from 64.9 to 36.4 from patients without pain to those with severe pain (P <0.001). According to PMI, 616 out of 752 patients reporting pain (82%) received inadequate analgesic treatment. Bone metastases were associated with improved adequacy and worst pain with reduced adequacy at multivariate analysis. In conclusion, pain is common in patients with advanced NSCLC, significantly affects QoL, and is frequently undertreated. We recommend that: (i) pain self-assessment should be part of oncological clinical practice; (ii) pain control should be a primary goal in clinical practice and in clinical trials; (iii) physicians should receive more training in pain management; (iv) analgesic treatment deserves greater attention in protocols of anticancer treatment.

AB - Pain is a highly distressing symptom for patients with advanced cancer. WHO analgesic ladder is widely accepted as a guideline for its treatment. Our aim was to describe pain prevalence among patients diagnosed with advanced non-small-cell lung cancer (NSCLC), impact of pain on quality of life (QoL) and adequacy of pain management. Data of 1021 Italian patients enrolled in three randomised trials of chemotherapy for NSCLC were pooled. QoL was assessed by EORTC QLQ-C30 and LC-13. Analgesic consumption during the 3 weeks following QoL assessment was recorded. Adequacy of pain management was evaluated by the Pain Management Index (PMI). Some pain was reported by 74% of patients (42% mild, 24% moderate and 7% severe); 50% stated pain was affecting daily activities (30% a little, 16% quite a bit, 336 very much). Bone metastases strongly affected presence of pain. Mean global QoL linearly decreased from 64.9 to 36.4 from patients without pain to those with severe pain (P <0.001). According to PMI, 616 out of 752 patients reporting pain (82%) received inadequate analgesic treatment. Bone metastases were associated with improved adequacy and worst pain with reduced adequacy at multivariate analysis. In conclusion, pain is common in patients with advanced NSCLC, significantly affects QoL, and is frequently undertreated. We recommend that: (i) pain self-assessment should be part of oncological clinical practice; (ii) pain control should be a primary goal in clinical practice and in clinical trials; (iii) physicians should receive more training in pain management; (iv) analgesic treatment deserves greater attention in protocols of anticancer treatment.

KW - Analgesics

KW - Cancer pain

KW - Lung cancer

KW - Pain Management Index

UR - http://www.scopus.com/inward/record.url?scp=3042696856&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3042696856&partnerID=8YFLogxK

M3 - Article

VL - 90

SP - 2288

EP - 2296

JO - British Journal of Cancer

JF - British Journal of Cancer

SN - 0007-0920

IS - 12

ER -