Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site Cohort
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Cancerologia (Online) |
Texto Completo: | https://rbc.inca.gov.br/index.php/revista/article/view/3299 |
Resumo: | Introduction: Pain is the main symptom described in cancer patients. Objective: To assess pain classification and management in pediatric patients with primary bone cancer over time: admission, during treatment and follow-up, and to investigate factors associated with pain classification at the last assessment. Method: Retrospective cohort study of osteosarcoma and Ewing's sarcoma cases in individuals <19 years old treated at a single cancer referral site and followed up by a multidisciplinary team. The primary endpoint was pain score at the last assessment. Secondary outcome: evolution of pharmacological treatment. Results: 142 patients were included. The frequency of pain assessment increased during the study period from 53.5% at admission to 68.3% during treatment and 85.9% in follow-up. Of the patients who had pain assessed, 65.8% had pain at admission and 26.2% at the end of the study. There was an increase in the use of strong opioids and antidepressants. In the last evaluation, 56 patients (39.4%) were at the end-of-life and this was not associated with more pain (p=0.68). Meanwhile, those who had more pain used strong opioids (p=0.01) or steroids (p=0.03). Conclusion: Pain management during treatment resulted in increased use of strong opioids and antidepressants with pain reduction, revealing that pain control is possible. In the last assessment, end-of-life patients no longer had pain and patients with pain were the ones who used strong opioids and steroids at the most, showing the difficulty of pain control in some patients. |
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Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site CohortEvaluación del Dolor en Pacientes Pediátricos con Cáncer Óseo Primario en una Cohorte de un Solo CentroAvaliação da Dor em Pacientes Pediátricos com Câncer Ósseo Primário em uma Coorte de um Centro Únicosarcoma de Ewingosteossarcomamanejo da dormorteneoplasias ósseassarcoma, Ewingosteosarcomapain managementdeathbone neoplasmssarcoma de Ewingosteosarcomamanejo del dolormuerteneoplasias óseasIntroduction: Pain is the main symptom described in cancer patients. Objective: To assess pain classification and management in pediatric patients with primary bone cancer over time: admission, during treatment and follow-up, and to investigate factors associated with pain classification at the last assessment. Method: Retrospective cohort study of osteosarcoma and Ewing's sarcoma cases in individuals <19 years old treated at a single cancer referral site and followed up by a multidisciplinary team. The primary endpoint was pain score at the last assessment. Secondary outcome: evolution of pharmacological treatment. Results: 142 patients were included. The frequency of pain assessment increased during the study period from 53.5% at admission to 68.3% during treatment and 85.9% in follow-up. Of the patients who had pain assessed, 65.8% had pain at admission and 26.2% at the end of the study. There was an increase in the use of strong opioids and antidepressants. In the last evaluation, 56 patients (39.4%) were at the end-of-life and this was not associated with more pain (p=0.68). Meanwhile, those who had more pain used strong opioids (p=0.01) or steroids (p=0.03). Conclusion: Pain management during treatment resulted in increased use of strong opioids and antidepressants with pain reduction, revealing that pain control is possible. In the last assessment, end-of-life patients no longer had pain and patients with pain were the ones who used strong opioids and steroids at the most, showing the difficulty of pain control in some patients.Introducción: El dolor es el principal síntoma descrito en pacientes oncológicos. Objetivo: Evaluar la clasificación y el manejo del dolor en pacientes pediátricos con cáncer óseo primario a lo largo del tiempo: registro, durante el tratamiento y seguimiento, e investigar los factores asociados entre la clasificación del dolor y última evaluación. Método: Estudio cohortes retrospectiva de casos de osteosarcoma y sarcoma de Ewing <19 años, tratados en único centro de referencia oncológica y seguidos por equipo multidisciplinar. Desenlace primario: calificación del dolor en la última evaluación. Desenlace secundario: evolución del tratamiento farmacológico. Resultados: Se incluyeron 142 pacientes. La frecuencia de evaluación del dolor aumentó durante el período de estudio del 53,5% al 68,3% y 85,9%. Los pacientes evaluados por dolor, el 65,8% tenía dolor al registro y 26,2% al final del estudio. Hubo aumento en el uso de opioides fuertes y antidepresivos. En la última evaluación, 56 pacientes (39,4%) estaban al final de su vida y esto no se asoció con más dolor (p=0,68), mientras que, quienes presentaron más dolor fueron quienes usaban opioides fuertes (p=0,01) o esteroides (p=0,03). Conclusión: Manejo del dolor durante el tratamiento resultó en un mayor uso de opioides fuertes y antidepresivos con reducción del dolor, revelando que es posible controlar el dolor. La última evaluación, pacientes al final de la vida ya no tenían dolor y pacientes con dolor eran los que más usaban opioides fuertes y esteroides, evidenciando la dificultad en el control del dolor en algunos pacientes.Introdução: A dor é o principal sintoma descrito em pacientes com câncer. Objetivo: Avaliar a classificação e o manejo da dor em pacientes pediátricos com câncer ósseo primário ao longo do tempo: admissão, durante o tratamento e acompanhamento, e investigar fatores associados à classificação da dor na última avaliação. Método: Estudo de coorte retrospectivo de casos de osteossarcoma e sarcoma de Ewing em indivíduos <19 anos, atendidos em único centro de referência de câncer e acompanhados por equipe multidisciplinar. Desfecho primário: classificação da dor na última avaliação. Desfecho secundário: evolução do tratamento farmacológico. Resultados: Foram incluídos 142 pacientes. A frequência de avaliação da dor aumentou durante o período do estudo de 53,5% na admissão para 68,3% durante o tratamento, chegando a 85,9% no acompanhamento. Dos pacientes cuja dor foi avaliada, 65,8% tiveram dor no recrutamento e 26,2% ao final do estudo. Houve aumento no uso de opioides fortes e antidepressivos. Na última avaliação, 56 pacientes (39,4%) estavam no fim da vida sem associação com mais dor (p=0,68), enquanto os que apresentaram mais dor foram aqueles que usavam opioides fortes (p=0,01) ou esteroides (p=0,03). Conclusão: O manejo da dor durante o tratamento resultou em aumento do uso de opioides fortes e antidepressivos com redução da dor, revelando que o controle da dor é possível. Na última avaliação, os pacientes em fim de vida não apresentavam mais dor, e os pacientes com dor foram os que mais utilizaram opioides fortes e esteroides, evidenciando a dificuldade no controle da dor em alguns pacientes.INCA2023-02-24info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionArtigos, Avaliado pelos paresapplication/pdftext/htmlhttps://rbc.inca.gov.br/index.php/revista/article/view/329910.32635/2176-9745.RBC.2023v69n1.3299Revista Brasileira de Cancerologia; Vol. 69 No. 1 (2023): Jan./Feb./Mar.; e-193299Revista Brasileira de Cancerologia; Vol. 69 Núm. 1 (2023): ene./feb./mar.; e-193299Revista Brasileira de Cancerologia; v. 69 n. 1 (2023): jan./fev./mar.; e-1932992176-9745reponame:Revista Brasileira de Cancerologia (Online)instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)instacron:INCAenghttps://rbc.inca.gov.br/index.php/revista/article/view/3299/2689https://rbc.inca.gov.br/index.php/revista/article/view/3299/2698Copyright (c) 2023 Revista Brasileira de Cancerologiahttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessAndrade, Flavio Ferreira deValete , Cristina Ortiz SobrinhoFerman, SimaSilva , André Ricardo Araújo2023-03-02T13:15:27Zoai:rbc.inca.gov.br:article/3299Revistahttps://rbc.inca.gov.br/index.php/revistaPUBhttps://rbc.inca.gov.br/index.php/revista/oairbc@inca.gov.br0034-71162176-9745opendoar:2023-03-02T13:15:27Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)false |
dc.title.none.fl_str_mv |
Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site Cohort Evaluación del Dolor en Pacientes Pediátricos con Cáncer Óseo Primario en una Cohorte de un Solo Centro Avaliação da Dor em Pacientes Pediátricos com Câncer Ósseo Primário em uma Coorte de um Centro Único |
title |
Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site Cohort |
spellingShingle |
Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site Cohort Andrade, Flavio Ferreira de sarcoma de Ewing osteossarcoma manejo da dor morte neoplasias ósseas sarcoma, Ewing osteosarcoma pain management death bone neoplasms sarcoma de Ewing osteosarcoma manejo del dolor muerte neoplasias óseas |
title_short |
Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site Cohort |
title_full |
Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site Cohort |
title_fullStr |
Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site Cohort |
title_full_unstemmed |
Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site Cohort |
title_sort |
Pain Assessment in Pediatric Patients with Primary Bone Cancer in a Single Site Cohort |
author |
Andrade, Flavio Ferreira de |
author_facet |
Andrade, Flavio Ferreira de Valete , Cristina Ortiz Sobrinho Ferman, Sima Silva , André Ricardo Araújo |
author_role |
author |
author2 |
Valete , Cristina Ortiz Sobrinho Ferman, Sima Silva , André Ricardo Araújo |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Andrade, Flavio Ferreira de Valete , Cristina Ortiz Sobrinho Ferman, Sima Silva , André Ricardo Araújo |
dc.subject.por.fl_str_mv |
sarcoma de Ewing osteossarcoma manejo da dor morte neoplasias ósseas sarcoma, Ewing osteosarcoma pain management death bone neoplasms sarcoma de Ewing osteosarcoma manejo del dolor muerte neoplasias óseas |
topic |
sarcoma de Ewing osteossarcoma manejo da dor morte neoplasias ósseas sarcoma, Ewing osteosarcoma pain management death bone neoplasms sarcoma de Ewing osteosarcoma manejo del dolor muerte neoplasias óseas |
description |
Introduction: Pain is the main symptom described in cancer patients. Objective: To assess pain classification and management in pediatric patients with primary bone cancer over time: admission, during treatment and follow-up, and to investigate factors associated with pain classification at the last assessment. Method: Retrospective cohort study of osteosarcoma and Ewing's sarcoma cases in individuals <19 years old treated at a single cancer referral site and followed up by a multidisciplinary team. The primary endpoint was pain score at the last assessment. Secondary outcome: evolution of pharmacological treatment. Results: 142 patients were included. The frequency of pain assessment increased during the study period from 53.5% at admission to 68.3% during treatment and 85.9% in follow-up. Of the patients who had pain assessed, 65.8% had pain at admission and 26.2% at the end of the study. There was an increase in the use of strong opioids and antidepressants. In the last evaluation, 56 patients (39.4%) were at the end-of-life and this was not associated with more pain (p=0.68). Meanwhile, those who had more pain used strong opioids (p=0.01) or steroids (p=0.03). Conclusion: Pain management during treatment resulted in increased use of strong opioids and antidepressants with pain reduction, revealing that pain control is possible. In the last assessment, end-of-life patients no longer had pain and patients with pain were the ones who used strong opioids and steroids at the most, showing the difficulty of pain control in some patients. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-02-24 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Artigos, Avaliado pelos pares |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/3299 10.32635/2176-9745.RBC.2023v69n1.3299 |
url |
https://rbc.inca.gov.br/index.php/revista/article/view/3299 |
identifier_str_mv |
10.32635/2176-9745.RBC.2023v69n1.3299 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/3299/2689 https://rbc.inca.gov.br/index.php/revista/article/view/3299/2698 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Revista Brasileira de Cancerologia https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Revista Brasileira de Cancerologia https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf text/html |
dc.publisher.none.fl_str_mv |
INCA |
publisher.none.fl_str_mv |
INCA |
dc.source.none.fl_str_mv |
Revista Brasileira de Cancerologia; Vol. 69 No. 1 (2023): Jan./Feb./Mar.; e-193299 Revista Brasileira de Cancerologia; Vol. 69 Núm. 1 (2023): ene./feb./mar.; e-193299 Revista Brasileira de Cancerologia; v. 69 n. 1 (2023): jan./fev./mar.; e-193299 2176-9745 reponame:Revista Brasileira de Cancerologia (Online) instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) instacron:INCA |
instname_str |
Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
instacron_str |
INCA |
institution |
INCA |
reponame_str |
Revista Brasileira de Cancerologia (Online) |
collection |
Revista Brasileira de Cancerologia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
repository.mail.fl_str_mv |
rbc@inca.gov.br |
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1797042234898513920 |