Health Utility of Pain Response Versus Nonresponse to Palliative Radiation Therapy for Symptomatic Bone Metastases: Analyses Based on Real-World Data from 26 Centers

<b><i>Background:</i></b> Utility values of responders and nonresponders are essential inputs in cost-effectiveness studies of radiation therapy for painful bone metastases but, to our knowledge, they have not been reported separately. <b><i>Objective:</i></b> We sought to determine the utility values of responders and nonresponders using data from a prospective observational study on bone metastases. <b><i>Methods:</i></b> The original prospective observational study was conducted at 26 centers in Japan. Of 232 enrolled patients, 181 whose pain scores at baseline were ≥2 were analyzed. Health-related quality of life (QOL) was measured using the EuroQol 5-dimensions 5-levels (EQ-5D-5L) instrument at baseline and 2- and 6-month follow-up assessments. At follow-up assessments, patients were categorized as responders or nonresponders. Pain response was assessed using the International Consensus Pain Response Endpoints. <b><i>Results:</i></b> Of the 181 patients analyzed, 133 (73%) and 84 (46%) were evaluable at the 2- and 6-month follow-up assessment, respectively. The EQ-5D-5L index score (utility) increased from baseline to the 2- and 6-month follow-up assessments; regarding opioid analgesic use, no clear trend was observed during the same period. The mean utility was significantly higher in responders than in nonresponders at both follow-up times. The mean daily oral morphine equivalent dose was significantly lower in responders than in nonresponders at both follow-up times. <b><i>Conclusion:</i></b> We determined utility values for responders and nonresponders. Pain response was associated with better QOL and less opioid use. Our utility values according to response status can be used for model input in future cost-effectiveness studies on radiation therapy for bone metastases.

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Publication Details

Journal
Journal of Palliative Medicine
Published
2024-12-27
DOI
https://doi.org/10.1089/jpm.2024.0208
Primary Topic
Management of metastatic bone disease
Type
article
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article

Health Utility of Pain Response Versus Nonresponse to Palliative Radiation Therapy for Symptomatic Bone Metastases: Analyses Based on Real-World Data from 26 Centers

Misako Miwa, Kayo Yoshida, Miho Watanabe, Joichi Heianna et al.
Journal of Palliative Medicine
Management of metastatic bone disease
article

Health Utility of Pain Response Versus Nonresponse to Palliative Radiation Therapy for Symptomatic Bone Metastases: Analyses Based on Real-World Data from 26 Centers

Misako Miwa, Kayo Yoshida, Miho Watanabe, Joichi Heianna, Norio Katoh, Akifumi Notsu, Hisayasu Nagakura, Haruka Uezono, Takeo Takahashi, Shigeo Takahashi, Nobue Uchida, Takafumi Komiyama, Ayako Tonari, Naoyuki Shigematsu, Tetsuo Saito, Yukinori Okada, Hikaru Kubota, Yasuo Ejima, Isao Asakawa, Takashi Kosugi, Hitoshi Wada, Hiroko Ikeda, Yutaro Koide, Takuya Yamazaki, Kei Ito, Kazunari Yamada, Naoki Nakamura, Naoto Shikama, Hiroki Shirato, Hideyuki Harada
article en

Abstract

<b><i>Background:</i></b> Utility values of responders and nonresponders are essential inputs in cost-effectiveness studies of radiation therapy for painful bone metastases but, to our knowledge, they have not been reported separately. <b><i>Objective:</i></b> We sought to determine the utility values of responders and nonresponders using data from a prospective observational study on bone metastases. <b><i>Methods:</i></b> The original prospective observational study was conducted at 26 centers in Japan. Of 232 enrolled patients, 181 whose pain scores at baseline were ≥2 were analyzed. Health-related quality of life (QOL) was measured using the EuroQol 5-dimensions 5-levels (EQ-5D-5L) instrument at baseline and 2- and 6-month follow-up assessments. At follow-up assessments, patients were categorized as responders or nonresponders. Pain response was assessed using the International Consensus Pain Response Endpoints. <b><i>Results:</i></b> Of the 181 patients analyzed, 133 (73%) and 84 (46%) were evaluable at the 2- and 6-month follow-up assessment, respectively. The EQ-5D-5L index score (utility) increased from baseline to the 2- and 6-month follow-up assessments; regarding opioid analgesic use, no clear trend was observed during the same period. The mean utility was significantly higher in responders than in nonresponders at both follow-up times. The mean daily oral morphine equivalent dose was significantly lower in responders than in nonresponders at both follow-up times. <b><i>Conclusion:</i></b> We determined utility values for responders and nonresponders. Pain response was associated with better QOL and less opioid use. Our utility values according to response status can be used for model input in future cost-effectiveness studies on radiation therapy for bone metastases.

Journal of Palliative MedicineVol. 28(1)
Chiba University (JP), St. Marianna University School of Medicine (JP), Keio University (JP), Hokkaido University (JP), Japanese Red Cross Society, Japan (JP), NTT Medical Center (JP), Tokyo Metropolitan Komagome Hospital (JP), Juntendo University (JP), Shizuoka Cancer Center (JP), Kobe University Hospital (JP), Seirei Mikatabara General Hospital (JP), Saiseikai Kumamoto Hospital (JP), Suita Tokushukai Hospital (JP), Kawasaki Municipal Hospital (JP), Osaka Minami Medical Center (JP), Aichi Cancer Center (JP), Kagawa University Hospital (JP), Fujieda Municipal General Hospital (JP), Kyorin University Hospital (JP), Social Insurance Saitama Chuo Hospital (JP), Hyogo Prefectural Cancer Center (JP), Southern Tohoku General Hospital (JP), Sendai Kousei Hospital (JP), Nara Medical University (JP), University of Yamanashi (JP), Dokkyo Medical University (JP), Saitama Medical University (JP)
Good health and well-being
Openalex Percentile: Top 55%
Management of metastatic bone disease
DOISourceOpenAlex
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