Kantonsspital St.Gallen
login

Quality of life and pain in patients with metastatic bone disease from solid tumors treated with bone-targeted agents- a real-world cross-sectional study from Switzerland (SAKK 95/16)

Karin Ribi, Beat Thürlimann, Corinne Schär, Daniel Dietrich, Richard Cathomas, Ursina Zürrer-Härdi, Thomas Von Briel, Sandro Anchisi, Pierre Bohanes, Veronika Blum, Philippe Von Burg, Meinrad Mannhart, Clemens B Caspar, Roger Von Moos & Michael Mark

abstract

BACKGROUND
Bone-targeted agents (BTAs) are widely used in the management of patients with bone metastases from solid tumors. Knowledge of the impact of their routine care use on patient-reported pain and bone pain-related quality of life (QoL) is limited.

METHODS
This real world, cross-sectional study enrolled patients over a 3-month period through oncologists across Switzerland. Patients were ≥ 18 years, had solid tumors and at least one bone metastasis, and received routine care for bone metastases. Physicians provided data on BTA-related practices, risk of bone complications and BTA regimen. Patients completed questionnaires about pain (BPI-SF), general and bone pain-related QoL (FACT-G, FACT-BP) and treatment satisfaction (FACIT-TS-G).

RESULTS
Eighteen sites recruited 417 patients. Based on the FACT-BP, 42% of the patients indicated not having bone pain. According to the BPI-SF, 28% reported no, 43% mild, 14% moderate, and 15% severe pain, respectively. Patients not treated with a BTA had better overall QoL (FACT-G: p = 0.031) and bone pain-related QoL (FACT-BP, p = 0.007) than those treated with a BTA. All pain and other QoL scales did not differ between groups. Patients perceived at 'low risk of bone complications' by their physician not receiving a BTA reported less pain and better QoL than those considered at 'low risk' but receiving BTA treatment or those considered at 'high risk' regardless of BTA treatment. Overall satisfaction with the treatment was good; almost 50% of patients reporting that they were completely satisfied.

CONCLUSIONS
Overall, pain and QoL did not differ according to BTA treatment or physicians' risk perception. Patient with low risks not receiving BTA treatment reported least pain and highest QoL scores. These results may suggest that treating physicians assess bone complication risk appropriately and treat patients accordingly, but they need to be confirmed by objective determination of longitudinal skeletal complication risk.
   
citation Ribi K, Thürlimann B, Schär C, Dietrich D, Cathomas R, Zürrer-Härdi U, von Briel T, Anchisi S, Bohanes P, Blum V, von Burg P, Mannhart M, Caspar C B, von Moos R, Mark M. Quality of life and pain in patients with metastatic bone disease from solid tumors treated with bone-targeted agents- a real-world cross-sectional study from Switzerland (SAKK 95/16). BMC Cancer 2021; 21:182.
   
type journal paper/review (English)
date of publishing 19-02-2021
journal title BMC Cancer (21/1)
ISSN electronic 1471-2407
pages 182
PubMed 33607966
DOI 10.1186/s12885-021-07903-8