Assessment of pain and nutritional status in patients undergoing palliative radiotherapy
Avaliação da dor e estado nutricional em pacientes submetidos à radioterapia paliativa
Patricia Mineiro de Oliveira; Victória Regina da Silva Oliveira; Jose Pinhata Otoch; Camila Squarzoni Dale
Abstract
BACKGROUND AND OBJECTIVES: Cancer pain has a high prevalence and significant psychosocial impact. Nutritional analysis and instrumental assessment of pain in cancer patients provide guidelines for better control, as nutritional status is a prognostic factor. The objective of this study was to investigate the characteristics of pain and its association with nutritional status in patients undergoing antalgic radiotherapy in a public hospital in the Brazilian Amazon.
METHODS: This is a prospective, non-randomized, observational study that enrolled forty-eight patients for palliative antalgic treatment in the Radiotherapy Department of the Hospital Regional do Baixo Amazonas (HRBA - Lower Amazonas Regional Hospital), Brazil. Validated questionnaires were used to assess and exclude comorbidities and pain symptoms. Data collection included uni and multidimensional instruments for pain analysis before and after radiotherapy, and analysis of clinical, epidemiological, and nutritional data.
RESULTS: Half of the patients were cachectic; the other half, who were not cachectic, were overweight patients with low appendicular lean mass. Patients responded well to antalgic radiotherapy both immediately and after 1 month of treatment. Cachectic patients had a higher score by the Visual Analogue Scale with significantly lower numerical reduction. Response rates were lower and deterioration after radiation occurred more frequently in this group. Cachectic patients had more neuropathic pain and longer pain duration. This group also presented a higher score for catastrophic thoughts about pain and a higher rate of anxiety and depression symptoms.
CONCLUSION: Considering the results obtained, a negative influence of poor nutritional status is observed on the response to antalgic irradiation and pain symptoms. This fact that must be considered when planning the treatment of cancer patients.
Keywords
Resumo
JUSTIFICATIVA E OBJETIVOS: A dor no câncer apresenta alta prevalência e impacto psicossocial significativo. À análise nutricional e a avaliação instrumental da dor em pacientes oncológicos fornecem diretrizes para um melhor controle, já que o estado nutricional é um fator prognóstico. O objetivo deste estudo foi investigar as características da dor e sua associação com o estado nutricional em pacientes submetidos à radioterapia antálgica em um hospital público na Amazônia Brasileira.
MÉTODOS: Este é um estudo observacional prospectivo, não randomizado, que envolveu 48 pacientes em tratamento paliativo antálgico no Departamento de Radioterapia do Hospital Regional do Baixo Amazonas (HRBA), Brasil. Questionários validados foram utilizados para avaliar e excluir comorbidades e sintomas de dor. A coleta de dados incluiu instrumentos unidimensionais e multidimensionais para análise da dor antes e após a radioterapia, além da análise de dados clínicos, epidemiológicos e nutricionais.
RESULTADOS: Metade dos pacientes apresentava caquexia; a outra metade, que não era caquética, era composta por pacientes com sobrepeso e baixa massa magra apendicular. Os pacientes responderam bem à radioterapia antálgica, tanto imediatamente, quanto após um mês de tratamento. Pacientes caquéticos apresentaram uma pontuação na escala analógica visual mais alta, com redução numérica significativamente menor. As taxas de resposta foram menores e a deterioração após a radiação ocorreu com mais frequência neste grupo. Pacientes caquéticos tiveram mais dor neuropática e maior duração da dor. Este grupo também apresentou uma pontuação mais alta para pensamentos catastróficos sobre a dor e uma maior taxa de sintomas de ansiedade e depressão.
CONCLUSÃO: Considerando os resultados obtidos, observou-se uma influência negativa do estado nutricional deficiente na resposta à irradiação antálgica e nos sintomas de dor. Esse fato deve ser considerado ao planejar o tratamento de pacientes com câncer.
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References
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Submitted date:
07/12/2024
Accepted date:
09/20/2024
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