Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Careful Breakthrough Cancer Pain Treatment through Rapid-Onset Transmucosal Fentanyl Improves the Quality of Life in Cancer Patients: Results from the BEST Multicenter Study

Arturo Cuomo
,
Marco Cascella
* ORCID logo ,
Cira Antonietta Forte
,
Sabrina Bimonte
ORCID logo ,
Gennaro Esposito
,
Stefano De Santis
ORCID logo ,
Luigi Cavanna
,
Flavio Fusco
,
Mario Dauri
,
Silvia Natoli
,
Marco Maltoni
,
Alessandro Morabito
,
Rocco Domenico Mediati
,
Vito Lorusso
,
Sandro Barni
,
Giampiero Porzio
,
Sebastiano Mercadante
,
Anna Crispo
Version 1 : Received: 11 February 2020 / Approved: 14 February 2020 / Online: 14 February 2020 (03:36:53 CET)

A peer-reviewed article of this Preprint also exists.

Cuomo, A.; Cascella, M.; Forte, C.A.; Bimonte, S.; Esposito, G.; De Santis, S.; Cavanna, L.; Fusco, F.; Dauri, M.; Natoli, S.; Maltoni, M.; Morabito, A.; Mediati, R.D.; Lorusso, V.; Barni, S.; Porzio, G.; Mercadante, S.; Crispo, A. Careful Breakthrough Cancer Pain Treatment through Rapid-Onset Transmucosal Fentanyl Improves the Quality of Life in Cancer Patients: Results from the BEST Multicenter Study. J. Clin. Med. 2020, 9, 1003. Cuomo, A.; Cascella, M.; Forte, C.A.; Bimonte, S.; Esposito, G.; De Santis, S.; Cavanna, L.; Fusco, F.; Dauri, M.; Natoli, S.; Maltoni, M.; Morabito, A.; Mediati, R.D.; Lorusso, V.; Barni, S.; Porzio, G.; Mercadante, S.; Crispo, A. Careful Breakthrough Cancer Pain Treatment through Rapid-Onset Transmucosal Fentanyl Improves the Quality of Life in Cancer Patients: Results from the BEST Multicenter Study. J. Clin. Med. 2020, 9, 1003.

Abstract

Objectives: To explore the effect of breakthrough cancer pain (BTcP) treatment on quality of sleep and other aspects of the health-related quality of life (HRQoL) in patients with cancer pain. Methods: In an observational, multicenter, cohort study, cancer patients from palliative care units, oncology departments, and pain clinics and affected by BTcP were included. Enrolled patients were assessed at the four visits: T0 (baseline), T7, T14, and T28. Well-controlled chronic background pain during the whole study period was mandatory. BTcP was treated through transmucosal fentanyl. Three questionnaires were used to measure the HRQoL: EORTC QLQ-C15-PAL, Pittsburgh Sleep Quality Index (PSQI), and the Edmonton Symptom Assessment System (ESAS). Results: In 154 patients, the HRQoL showed a significant improvement for all physical and emotional characteristics in the EORTC QLQ-C15-PAL, except for nausea and vomiting (Linear p-value = 0.1) and dyspnoea (Linear p-value =0.05). The ESAS and PSQI questionnaires confirmed these positive results (p<0.0001 and p=0.002, respectively). Conclusions: This prospective investigation by an Italian expert group, has confirmed that careful management of BTcP induces a paramount improvement on the HRQoL. Because in cancer patients there is a high prevalence of BTcP and this severe acute pain has deleterious consequences, this information can have an important clinical significance

Keywords

breakthrough cancer pain; cancer-associated pain; cancer; health-related quality of life; sleep disorders; transmucosal fentanyl

Subject

Medicine and Pharmacology, Anesthesiology and Pain Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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