Cancers (Jun 2018)
Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients
- Sebastiano Mercadante,
- Paolo Marchetti,
- Arturo Cuomo,
- Augusto Caraceni,
- Rocco Domenico Mediati,
- Renato Vellucci,
- Massimo Mammucari,
- Silvia Natoli,
- Marzia Lazzari,
- Mario Dauri,
- Claudio Adile,
- Mario Airoldi,
- Giuseppe Azzarello,
- Mauro Bandera,
- Livio Blasi,
- Giacomo Cartenì,
- Bruno Chiurazzi,
- Benedetta Veruska Pierpaola Costanzo,
- Daniela Degiovanni,
- Flavio Fusco,
- Vittorio Guardamagna,
- Vincenzo Iaffaioli,
- Simeone Liguori,
- Loredana Palermo,
- Sergio Mameli,
- Francesco Masedu,
- Rodolfo Mattioli,
- Teresita Mazzei,
- Rita Maria Melotti,
- Valentino Menardo,
- Danilo Miotti,
- Stefano Moroso,
- Gaetano Pascoletti,
- Stefano De Santis,
- Remo Orsetti,
- Alfonso Papa,
- Sergio Ricci,
- Elvira Scelzi,
- Michele Sofia,
- Giuseppe Tonini,
- Alessandro Valle,
- Federica Aielli,
- on behalf of the IOPS-MS Study Group
Affiliations
- Sebastiano Mercadante
- Anesthesia and Intensive Care & Pain Relief and Supportive Care, La Maddalena, 90146 Palermo, Italy
- Paolo Marchetti
- Molecular and Clinical Medicine Medical Oncology, La Sapienza University of Rome, 00155 Rome, Italy
- Arturo Cuomo
- Anesthesiology, Resuscitation, and Pain Therapy Department, National Cancer Institute, IRCCS Foundation Pascale, 80131 Naples, Italy
- Augusto Caraceni
- Palliative Care, Pain Therapy and Rehabilitation, National Cancer Institute, IRCCS Foundation, 20133 Milan, Italy
- Rocco Domenico Mediati
- Palliative Care and Pain Therapy Unit, Careggi Hospital, 50139 Florence, Italy
- Renato Vellucci
- Palliative Care and Pain Therapy Unit, Careggi Hospital, 50139 Florence, Italy
- Massimo Mammucari
- Primary Care Unit, ASL RM1, 00165 Rome, Italy
- Silvia Natoli
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Marzia Lazzari
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Mario Dauri
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Claudio Adile
- Anesthesia and Intensive Care & Pain Relief and Supportive Care, La Maddalena, 90146 Palermo, Italy
- Mario Airoldi
- Second Medical Oncology Division, Città della Salute e della Scienza Hospital of Turin, 10126 Turin, Italy
- Giuseppe Azzarello
- Medical Specialties Department, Oncology and Oncologic Hematology, ASL 13 Mirano, 30035 Venice, Italy
- Mauro Bandera
- Medical Oncology Unit, Ospedale di Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
- Livio Blasi
- Medical Oncology Unit, ARNAS Ospedale Civico Di Cristina Benfratelli, 90127 Palermo, Italy
- Giacomo Cartenì
- Medical Oncology, A.O.R.N. Cardarelli, 80131 Naples, Italy
- Bruno Chiurazzi
- Medical Oncology, A.O.R.N. Cardarelli, 80131 Naples, Italy
- Benedetta Veruska Pierpaola Costanzo
- Palliative Care Unit, SAMO ONLUS, 95131 Catania, Italy
- Daniela Degiovanni
- Palliative Care Unit, ASL AL, 15033 Casale Monferrato, Italy
- Flavio Fusco
- Palliative Care Unit, Department of Primary and Community Care, ASL 3 Genovese, 16125 Genoa, Italy
- Vittorio Guardamagna
- Palliative Care and Pain Therapy Unit, European Oncology Institute IRCCS, 20141 Milan, Italy
- Vincenzo Iaffaioli
- Abdominal Medical Oncology, National Cancer Institute, IRCCS Foundation Pascale, 80131 Naples, Italy
- Simeone Liguori
- Palliative Care and Pain Therapy Unit, Papa Giovanni XXIII Hospital, 24121 Bergamo, Italy
- Loredana Palermo
- Medical Oncology Unit, National Cancer Research Center “Giovanni Paolo II”, 70124 Bari, Italy
- Sergio Mameli
- Pain Therapy Unit, “A. Businco” Hospital, ASL 8, 09134 Cagliari, Italy
- Francesco Masedu
- Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L’Aquila, 67100 L’Aquila, Italy
- Rodolfo Mattioli
- Medical Oncology Unit, S. Croce Hospital, 61032 Fano-Pesaro, Italy
- Teresita Mazzei
- Section of Clinical Pharmacology and Oncology, Department of Health Sciences, University of Florence, 50139 Florence, Italy
- Rita Maria Melotti
- Department of Medicine and Surgery Sciences, University of Bologna, 40126 Bologna, Italy
- Valentino Menardo
- PainTherapy, S. Croce e Carle Hospital, 12100 Cuneo, Italy, <email>[email protected]</email>
- Danilo Miotti
- Pain Therapy ICS Maugeri, IRCCS Foundation 27100 Pavia, Italy
- Stefano Moroso
- Medical Oncology, Azienda Sanitaria Universitaria Integrata di Trieste, 34128 Trieste, Italy
- Gaetano Pascoletti
- Medical Oncology, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy
- Stefano De Santis
- Palliative Care and Oncologic Pain Service, S. Camillo-Forlanini Hospital, 00152 Rome, Italy
- Remo Orsetti
- Pain Medicine Unit, S. Camillo-Forlanini Hospital, 00152 Rome, Italy
- Alfonso Papa
- Pain Relief, A.O. Dei Colli, Monaldi Hospital, 80131 Naples, Italy
- Sergio Ricci
- Division of Medical Oncology, Department of Oncology, S. Chiara University Hospital, 56126 Pisa, Italy
- Elvira Scelzi
- Medical Oncology, Castelfranco Veneto Hospital, 31033Treviso, Italy
- Michele Sofia
- Department of Palliative Care with Hospice and Pain therapy Unit, “G. Salvini” Hospital, Garbagnate Milanese, 20024 Milan, Italy
- Giuseppe Tonini
- Department of Medical Oncology, Campus Bio-Medico University of Rome, 00128 Rome, Italy
- Alessandro Valle
- Palliative Care, FARO Foundation, 10133 Turin, Italy
- Federica Aielli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy
- on behalf of the IOPS-MS Study Group
- Membership of the Italian Oncologic Pain Multisetting Multicentric Survey (IOPS-MS) Study Group is provided in the Acknowledgments.
- DOI
- https://doi.org/10.3390/cancers10060175
- Journal volume & issue
-
Vol. 10,
no. 6
p. 175
Abstract
Background: The aim of this study was to identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP). Methods: Cancer patients with a diagnosis of BTP were enrolled. Demographic and clinical characteristics, as well as background pain and BTP characteristics were collected. Multivariate analyses were conducted to assess the correlation between BTP characteristics and the variables examined. Results: Data of 4016 patients were analysed. Average daily number of BTP episodes was 2.4, mean intensity was 7.5, and a mean duration was 43.3 min. A short onset BTP was observed in 68.9% of patients. In 30.5% of patients BTP was predictable. There were 86.0% of participants who reported a marked interference of BTP with their daily activities. Furthermore, 86.8% of patients were receiving opioids for the management of BTP. The average time to meaningful pain relief was 16.5 min and 70.9% of patients were satisfied with their BTP medications. Age, head and neck cancer, Karnofsky, background pain intensity, predictable and fast onset BTP were independently associated with the number of BTP episodes. BTP pain intensity was independently associated with background pain intensity, fast onset BTP, and Karnofsky. Neuropathic pain mechanism was independently associated with unpredictable BTP. Variables independently associated with a longer duration of BTP were age, place of visit, cancer diagnosis, disease-oriented therapy, background pain intensity and mechanism, and unpredictable BTP. Age, Karnofsky, background pain intensity, fast onset, and long duration of BTP were independently associated with interference with daily activity. Conclusions: BTP has a variable presentation depending on interdependent relationships among its different characteristics.
Keywords
