Patients with multiple bony metastases from solid tumors may receive wide field radiation therapy for pain palliation. The benefit of the therapy can be measured using some simple scores which can be used to compare the effects of different therapeutic regimens.
Measures:
(1) pain score before and after therapy
(2) drug score before and after therapy
(3) percent pain relief
(4) percent net pain relief
|
Pain Parameter |
Measure |
Points |
|
Pain type (Severity) |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
Pain frequency |
no pain |
0 |
|
|
occasional (less than daily) |
1 |
|
|
intermittent (one or more times daily) |
2 |
|
|
constant (most of the time) |
3 |
|
Drug Parameter |
Measure |
Points |
|
Drug type |
none |
0 |
|
|
analgesic (aspirin, Tylenol, etc.) |
1 |
|
|
mild narcotic (0.5 grain codeine, Percodan) |
2 |
|
|
strong narcotic (>= 1 grain codeine, morphine, demerol) |
3 |
|
Drug frequency |
none given |
0 |
|
|
less than daily |
1 |
|
|
once daily |
2 |
|
|
more than once daily |
3 |
pain score
= (pain type) * (pain frequency)
drug score =
= (drug type) * (drug frequency)
percent pain relief =
= 100 * (1 - ((pain score after radiation) / (pain score before radiation)))
percent net pain relief =
= 100 * ((duration of pain relief) / (survival after radiation therapy))
Interpretation:
• minimum pain or drug score: 0
• maximum pain or drug score: 9
Purpose: To use a simple score to evaluate effectiveness of wide field radiation therapy for palliation of pain from multiple bony metastases.
Specialty: Hematology Oncology
Objective: response to therapy, end-of-life, palliative care
ICD-10: C40, C41,
