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Snijders RAH, Brom L, Theunissen M, van den Beuken-van Everdingen MHJ. Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis. Cancers (Basel) 2023; 15:591. [PMID: 36765547 PMCID: PMC9913127 DOI: 10.3390/cancers15030591] [Citation(s) in RCA: 74] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Experiencing pain and insufficient relief can be devastating and negatively affect a patient's quality of life. Developments in oncology such as new treatments and adjusted pain management guidelines may have influenced the prevalence of cancer pain and severity in patients. This review aims to provide an overview of the prevalence and severity of pain in cancer patients in the 2014-2021 literature period. A systematic literature search was performed using the databases PubMed, Embase, CINAHL, and Cochrane. Titles and abstracts were screened, and full texts were evaluated and assessed on methodological quality. A meta-analysis was performed on the pooled prevalence and severity rates. A meta-regression analysis was used to explore differences between treatment groups. We identified 10,637 studies, of which 444 studies were included. The overall prevalence of pain was 44.5%. Moderate to severe pain was experienced by 30.6% of the patients, a lower proportion compared to previous research. Pain experienced by cancer survivors was significantly lower compared to most treatment groups. Our results imply that both the prevalence of pain and pain severity declined in the past decade. Increased attention to the assessment and management of pain might have fostered the decline in the prevalence and severity of pain.
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Affiliation(s)
- Rolf A. H. Snijders
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research & Development, 3511 DT Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), 3511 DT Utrecht, The Netherlands
| | - Linda Brom
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research & Development, 3511 DT Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), 3511 DT Utrecht, The Netherlands
| | - Maurice Theunissen
- Centre of Expertise for Palliative Care, Maastricht University Medical Centre+ (MUMC+), 6229 HX Maastricht, The Netherlands
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Centre+ (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Marieke H. J. van den Beuken-van Everdingen
- Centre of Expertise for Palliative Care, Maastricht University Medical Centre+ (MUMC+), 6229 HX Maastricht, The Netherlands
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Centre+ (MUMC+), 6229 HX Maastricht, The Netherlands
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Pathy S, Thimmarayappa A, Malik P, Mallick S, Upadhyay A. Treatment outcomes and prognostic factors in locally advanced non-small cell lung cancer – An experience from normal India. J Cancer Res Ther 2021; 18:27-32. [DOI: 10.4103/jcrt.jcrt_1855_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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van de Kamp HJ, Molder MT, Schulkes KJG, Stellingwerf M, van Elden LJR, van Lindert ASR, Hamaker ME. Impact of Lung Cancer Treatment on Cognitive Functioning. Clin Lung Cancer 2019; 21:114-126.e3. [PMID: 31839534 DOI: 10.1016/j.cllc.2019.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/18/2019] [Accepted: 06/05/2019] [Indexed: 12/30/2022]
Abstract
The impact of oncologic treatment for (non)-small-cell lung cancer (NSCLC and SCLC, respectively) on cognition is relevant when deciding which treatment is the most preferable option, especially when curation is not possible. A systematic search of Medline and EMBASE for studies on the effect of treatment on cognition in patients with lung cancer was performed. A total of 39 longitudinal articles were included. Study populations were heterogeneous with regards to stage and treatment type. In the 7 studies concerning SCLC, the median age of patients was between 59 and 68 years. Eighty-six percent of these studies had a loss to follow-up > 10%. Six studies used objective tests to assess cognition. Objective measurements showed a negative effect on attention, memory, and fluency after treatment. Thirty-three studies concerning NSCLC were included. The mean age of patients was between 53 and 77 years. Seventy percent of these studies included patients with stage III and IV NSCLC. Over one-half of the studies had a high rate of loss to follow-up. Eighty-eight percent used objective scales to assess cognitive functioning. Subjective decline of cognitive functioning up to 11.1% was experienced, with recovery at 4 to 6 months. Objective measurement of attention showed improvement over the course of chemotherapy. In SCLC, there is a significant negative effect on attention, memory, and fluency. In NSCLC, the longer term impact of treatment on both subjective and objective cognitive functioning appears limited. Thus, there is no evidence directing treatment choice for NSCLC based on longer term cognitive deficits. Further research is needed to precisely assess the impact of lung cancer treatment on cognition.
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Affiliation(s)
| | - Marthe Te Molder
- Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
| | - Karlijn J G Schulkes
- Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Margriet Stellingwerf
- Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Anne S R van Lindert
- Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
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Hypofractionated Concomitant Chemoradiation in Inoperable Locally Advanced Non-small Cell Lung Cancer: A Report on 100 Patients and a Systematic Review. Clin Oncol (R Coll Radiol) 2018; 31:e1-e10. [PMID: 30415784 DOI: 10.1016/j.clon.2018.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/25/2018] [Indexed: 01/14/2023]
Abstract
AIMS Concomitant chemoradiation is the standard of care in patients with inoperable non-small cell lung cancer. The purpose of this study was to analyse the survival outcome and toxicity data of using hypofractionated chemoradiation. MATERIALS AND METHODS One hundred patients were treated from June 2011 to November 2016. Treatment consisted of 55 Gy in 20 daily fractions concurrently with split-dose cisplatin vinorelbine chemotherapy over 4 weeks followed by two cycles of cisplatin vinorelbine only. Survival was estimated using Kaplan-Meier and Cox regression was carried out for known prognostic factors. A systematic search of literature was conducted using Medline, Embase and Cochrane databases and relevant references included. RESULTS In total, 97% of patients completed radiotherapy and 73% of patients completed all four cycles of chemotherapy. One patient died of a cardiac event during consolidative chemotherapy. There were two cases of grade 4 toxicities (one sepsis, one renal impairment). Grade 3 toxicities included nausea/vomiting (17%), oesophagitis (15%), infection with neutropenia (12%) and pneumonitis (4%). Clinical benefit was seen in 86%. Two-year progression-free survival and overall survival rates were 49% and 58%, respectively. The median progression-free survival and overall survival were 23.4 and 43.4 months, respectively. The only significant prognostic factor was the number of chemotherapy cycles received (P = 0.02). The systematic review identified 13 relevant studies; a variety of regimens were assessed with variable reporting of outcomes and toxicity but with overall an improvement in survival over time. CONCLUSION Our experience compared with the original phase II trial showed improved treatment completion rates and survival with acceptable morbidity. With appropriate patient selection this regimen is an effective treatment option for locally advanced non-small cell lung cancer. This study helps to benchmark efficacy and toxicity rates while considering the addition of new agents to hypofractionated concurrent chemoradiotherapy. The agreement of a standard regimen for assessment in future trials would be beneficial.
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Chen G, Sheng L, Du X. Efficacy and safety of liposome-paclitaxel and carboplatin based concurrent chemoradiotherapy for locally advanced lung squamous cell carcinoma. Cancer Chemother Pharmacol 2018; 82:505-510. [PMID: 29987370 DOI: 10.1007/s00280-018-3640-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/03/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy and toxicities of liposome-paclitaxel and carboplatin concurrent with radiotherapy for locally advanced lung squamous cell carcinoma (LSCC). METHODS The clinical data of 38 patients with locally advanced LSCC treated with liposome-paclitaxel based concurrent chemoradiotherapy were collected and reviewed. The overall response, toxicities, progression-free survival and overall survival were analyzed with SPSS software. RESULT The efficacy of treatment was classified as complete remission in 4 cases (10.5%), partial remission in 22 cases (57.9%) and stable disease in 12 cases (31.6%). The objective response rate was 68.4% (26/38). The most common types of hematological toxicities were anemia (65.7%) and leukopenia (57.9%), but all the events were transient. No paclitaxel-induced allergic reactions occurred during the treatment. The median PFS and OS time were 17.0 and 29.0 months. CONCLUSIONS Liposome-paclitaxel and carboplatin concurrent with radiotherapy showed a significant antitumor effect to LSCC with manageable toxicities. Further clinical investigation are warranted to evaluate the efficacy of this regimen.
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Affiliation(s)
- Guofu Chen
- Department of Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China.,Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Cancer Hospital, 1 Banshandong Road, Hangzhou, 310022, Zhejiang, China
| | - Liming Sheng
- Department of Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China. .,Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Cancer Hospital, 1 Banshandong Road, Hangzhou, 310022, Zhejiang, China.
| | - Xianghui Du
- Department of Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China. .,Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Cancer Hospital, 1 Banshandong Road, Hangzhou, 310022, Zhejiang, China.
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Roy S, Badragan I, Ahmed SN, Sia M, Singh J, Bahl G. Integration of radiobiological modeling and indices in comparative plan evaluation: A study comparing VMAT and 3D-CRT in patients with NSCLC. Pract Radiat Oncol 2018; 8:e355-e363. [PMID: 29703705 DOI: 10.1016/j.prro.2018.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/08/2018] [Accepted: 02/23/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE The purpose of this article was to generate an algorithm to calculate radiobiological endpoints and composite indices and use them to compare volumetric modulated arc therapy (VMAT) and 3-dimensional conformal radiation therapy (3D-CRT) techniques in patients with locally advanced non-small cell lung cancer. METHODS AND MATERIALS The study included 25 patients with locally advanced non-small cell lung cancer treated with 3D-CRT at our center between January 1, 2010, and December 31, 2014. The planner generated VMAT plans using clones of the original computed tomography scans and regions of interest volumes, which did not include the original 3D plans. Both 3D-CRT and VMAT plans were generated using the same dose-volume constraint worksheet. The dose-volume histogram parameters for planning target volume and relevant organs at risk (OAR) were reviewed. The calculation engine was written in the R programming language; the user interface was developed with the "shiny" R Web library. Dose-volume histogram data were imported into the calculation engine and tumor control probability (TCP), normal tissue complication probability (NTCP), composite cardiopulmonary toxicity index (CPTI), morbidity index: MI = ∑j = 1#ofrelevantOARs(wj ∗ NTCPj), uncomplicated TCP (UTCP=TCP∗∏k=1#ofOARs1-NTCPK100, and therapeutic gain (TG): ie, TG = TCP ∗ (100 - MI) were calculated. RESULTS TCP was better with 3D-CRT (12.62% vs 11.71%, P < .001), whereas VMAT demonstrated superior NTCP esophagus (4.45% vs 7.39%, P = .02). NTCP spinal cord (0.001% vs 0.009%, P = .001), and NTCP heart/perfusion defect (44.57% vs 56.42%, P = .016). There was no difference in NTCP lung (6.27% vs 7.62%, P = .221) and NTCP heart/pericarditis (0.001% vs 0.15%, P = .129) between 2 techniques. VMAT showed substantial improvement in morbidity index (11.06% vs. 14.31%, P = 0.01), CPTI (47.59% vs 59.41%, P = .03), TG (P = .035), and trend toward superiority in UTCP (5.89 vs 4.75, P=.057). CONCLUSION The study highlights the utility of the radiobiological algorithm and summary indices in comparative plan evaluation and demonstrates benefits of VMAT over 3D-CRT.
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Affiliation(s)
- Soumyajit Roy
- Department of Radiation Oncology, British Columbia Cancer Agency-Abbotsford Center, Canada; Division of Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Canada
| | - Iulian Badragan
- Department of Radiation Oncology, British Columbia Cancer Agency-Abbotsford Center, Canada
| | - Sheikh Nisar Ahmed
- Department of Radiation Oncology, British Columbia Cancer Agency-Abbotsford Center, Canada; Division of Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Canada
| | - Michael Sia
- Department of Radiation Oncology, British Columbia Cancer Agency-Abbotsford Center, Canada; Division of Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Canada
| | - Jorawur Singh
- Department of Radiation Oncology, British Columbia Cancer Agency-Abbotsford Center, Canada
| | - Gaurav Bahl
- Department of Radiation Oncology, British Columbia Cancer Agency-Abbotsford Center, Canada; Division of Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Canada.
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van der Weijst L, Surmont V, Schrauwen W, Lievens Y. Systematic literature review of health-related quality of life in locally-advanced non-small cell lung cancer: Has it yet become state-of-the-art? Crit Rev Oncol Hematol 2017; 119:40-49. [PMID: 29065984 DOI: 10.1016/j.critrevonc.2017.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/04/2017] [Accepted: 09/26/2017] [Indexed: 01/13/2023] Open
Abstract
Lung cancer and its treatment have an important impact on the patients' health-related quality-of-life (HRQoL). A systematic literature review of prospective clinical studies published since 2005 and measuring HRQoL in patients with locally-advanced non-small cell lung cancer (LA- NSCLC) was performed. Besides reviewing the HRQoL impact of LA-NSCLC treatment, it critically examined the frequency, methodology and quality of HRQoL data collection and analysis in LA-NSCLC clinical studies. Out of 814 potentially eligible publications, only 27 (representing 19 individual studies) met the inclusion criteria. Eight studies documented an impact on HRQoL. Large variability in use of HRQoL instruments, statistical analysis and methodological quality was observed. Reporting of HRQoL data lacks standardization, but recent initiatives establishing recommendations to standardize the analysis and reporting of HRQoL in cancer trials are expected to address these issues. Overall, more research is needed to evaluate the treatment impact on HRQoL in both clinical trials and daily care.
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Affiliation(s)
- Lotte van der Weijst
- Department of Radiation Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium.
| | - Veerle Surmont
- Department of Respiratory Medicine, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Wim Schrauwen
- Department of Medical Psychology, Ghent University Hospital, Ghent, Belgium
| | - Yolande Lievens
- Department of Radiation Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium
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Neoadjuvant approach for nonsmall cell lung cancer: overview of the current issues. Curr Opin Oncol 2017; 29:123-128. [DOI: 10.1097/cco.0000000000000354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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