TY - JOUR
T1 - Characterization of risk factors for adjuvant radiotherapy-associated pain in a tri-racial/ethnic breast cancer population
AU - Lee, Eunkyung
AU - Takita, Cristiane
AU - Wright, Jean L.
AU - Reis, Isildinha M.
AU - Zhao, Wei
AU - Nelson, Omar L.
AU - Hu, Jennifer J.
N1 - Funding Information:
We thank all study subjects, Martine Poitevien, Onaidy T. Torres, Johnny H. Galli, and the clinical staff at the radiation oncology clinics for their support. This study was supported by the National Institutes of Health grant CA135288 (J.J.H.) and the Sheila and David Fuente Neuropathic Pain Pre-Doctoral fellowship (E.L).
Publisher Copyright:
© 2016 International Association for the Study of Pain.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Pain related to cancer or treatment is a critical quality of life issue for breast cancer survivors. In a prospective study of 375 patients with breast cancer (enrolled during 2008-2014), we characterized the risk factors for adjuvant radiotherapy (RT)-associated pain. Pain score was assessed at pre-RT and post-RT as the mean of 4 pain severity items (ie, pain at its worst, least, average, and now) from the Brief Pain Inventory with 11-point numeric rating scale (0-10). Pain scores of 4 to 10 were considered clinically relevant pain. The study consists of 58 non-Hispanic whites (15%), 78 black or African Americans (AA; 21%), and 239 Hispanic whites (HW; 64%). Overall, the prevalence of pre-RT, post-RT, and RT-associated clinically relevant pain was 16%, 31% and 20%, respectively. In univariate analysis, AA and HW had significantly higher pre-RT and post-RT pain than non-Hispanic whites. In multivariable logistic regression analysis, pre-RT pain was significantly associated with HW and obesity; post-RT pain was significantly associated with AA, HW, younger age, ≥2 comorbid conditions, above-median hotspot volume receiving >105% prescribed dose, and pre-RT pain score ≥4. Radiotherapy-associated pain was significantly associated with AA (odds ratio [OR] 3.27; 95% confidence interval [CI] 1.09-9.82), younger age (OR 2.44, 95% CI 1.24-4.79), and 2 or ≥3 comorbid conditions (OR 3.06, 95% CI 1.32-7.08; OR 4.61, 95% CI 1.49-14.25, respectively). These risk factors may help to guide RT decision-making process, such as hypofractionated RT schedule. Furthermore, effective pain management strategies are needed to improve quality of life in patients with breast cancer with clinically relevant pain.
AB - Pain related to cancer or treatment is a critical quality of life issue for breast cancer survivors. In a prospective study of 375 patients with breast cancer (enrolled during 2008-2014), we characterized the risk factors for adjuvant radiotherapy (RT)-associated pain. Pain score was assessed at pre-RT and post-RT as the mean of 4 pain severity items (ie, pain at its worst, least, average, and now) from the Brief Pain Inventory with 11-point numeric rating scale (0-10). Pain scores of 4 to 10 were considered clinically relevant pain. The study consists of 58 non-Hispanic whites (15%), 78 black or African Americans (AA; 21%), and 239 Hispanic whites (HW; 64%). Overall, the prevalence of pre-RT, post-RT, and RT-associated clinically relevant pain was 16%, 31% and 20%, respectively. In univariate analysis, AA and HW had significantly higher pre-RT and post-RT pain than non-Hispanic whites. In multivariable logistic regression analysis, pre-RT pain was significantly associated with HW and obesity; post-RT pain was significantly associated with AA, HW, younger age, ≥2 comorbid conditions, above-median hotspot volume receiving >105% prescribed dose, and pre-RT pain score ≥4. Radiotherapy-associated pain was significantly associated with AA (odds ratio [OR] 3.27; 95% confidence interval [CI] 1.09-9.82), younger age (OR 2.44, 95% CI 1.24-4.79), and 2 or ≥3 comorbid conditions (OR 3.06, 95% CI 1.32-7.08; OR 4.61, 95% CI 1.49-14.25, respectively). These risk factors may help to guide RT decision-making process, such as hypofractionated RT schedule. Furthermore, effective pain management strategies are needed to improve quality of life in patients with breast cancer with clinically relevant pain.
KW - Breast cancer
KW - Cancer disparities
KW - Cancer survivorship
KW - Pain
KW - Radiotherapy
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U2 - 10.1097/j.pain.0000000000000489
DO - 10.1097/j.pain.0000000000000489
M3 - Article
C2 - 26780493
AN - SCOPUS:84964703082
SN - 0304-3959
VL - 157
SP - 1122
EP - 1131
JO - Pain
JF - Pain
IS - 5
ER -