Evaluation of Changes in Activities of Daily Living and Quality of Life of Patients with Bone Metastasis Who Underwent Conservative Therapy through Bone Metastasis Cancer Boards
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethics Statement
2.2. Participants and Data Collection
2.3. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Uchida, A.; Wakabayashi, H.; Okuyama, N.; Okamura, A.; Matsumine, A.; Kusuzaki, K. Metastatic bone disease: Pathogenesis and new strategies for treatment. J. Orthop. Sci. 2004, 9, 415–420. [Google Scholar] [CrossRef] [PubMed]
- Hage, W.D.; Aboulafia, A.J.; Aboulafia, D.M. Incidence, location, and diagnostic evaluation of metastatic bone disease. Orthop. Clin. N. Am. 2000, 31, 515–528. [Google Scholar] [CrossRef] [PubMed]
- Piccioli, A.; Maccauro, G.; Spinelli, M.S.; Biagini, R.; Rossi, B. Bone metastases of unknown origin: Epidemiology and principles of management. J. Orthop. Traumatol. 2015, 16, 81–86. [Google Scholar] [CrossRef] [PubMed]
- Huang, J.F.; Shen, J.; Li, X.; Rengan, R.; Silvestris, N.; Wang, M.; Derosa, L.; Zheng, X.; Belli, A.; Zhang, X.L.; et al. Incidence of patients with bone metastases at diagnosis of solid tumors in adults: A large population-based study. Ann. Transl. Med. 2020, 8, 482. [Google Scholar] [CrossRef] [PubMed]
- Tseng, C.L.; Eppinga, W.; Charest-Morin, R.; Soliman, H.; Myrehaug, S.; Maralani, P.J.; Campbell, M.; Lee, Y.K.; Fisher, C.; Fehlings, M.G.; et al. Spine stereotactic body radiotherapy: Indications, outcomes, and points of caution. Glob. Spine J. 2017, 7, 179–197. [Google Scholar] [CrossRef] [PubMed]
- Hosono, N.; Yonenobu, K.; Fuji, T.; Ebara, S.; Yamashita, K.; Ono, K. Orthopaedic management of spinal metastases. Clin. Orthop. Relat. Res. 1995, 312, 148–159. [Google Scholar]
- Coleman, R.E. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin. Cancer Res. 2006, 12, 6243s–6249s. [Google Scholar] [CrossRef] [PubMed]
- Coleman, R.E. Bisphosphonates: Clinical experience. Oncologist 2004, 9 (Suppl. S4), 14–27. [Google Scholar] [CrossRef]
- Schulman, K.L.; Kohles, J. Economic burden of metastatic bone disease in the U.S. Cancer. Cancer 2007, 109, 2334–2342. [Google Scholar] [CrossRef]
- Coleman, R.E. Metastatic bone disease: Clinical features, pathophysiology and treatment strategies. Cancer Treat. Rev. 2001, 27, 165–176. [Google Scholar] [CrossRef]
- Ibrahim, T.; Mercatali, L.; Amadori, D.D. Bone and cancer: The osteoncology. Clin. Cases Miner. Bone Metab. 2013, 10, 121–123. [Google Scholar] [PubMed]
- Bongiovanni, A.; Recine, F.; Fausti, V.; Foca, F.; Casadei, R.; Falasconi, M.C.; Oboldi, D.; Sansoni, E.; Fabbri, L.; Micheletti, S.; et al. Ten-year experience of the multidisciplinary Osteoncology Center. Support. Care Cancer 2019, 27, 3395–3402. [Google Scholar] [CrossRef] [PubMed]
- Farmani, A.R.; Nekoofar, M.H.; Ebrahimi-Barough, S.; Azami, M.; Najafipour, S.; Moradpanah, S.; Ai, J. Preparation and in vitro osteogenic evaluation of biomimetic hybrid nanocomposite scaffolds based on gelatin/plasma rich in growth factors (PRGF) and lithium-doped 45s5 bioactive glass nanoparticles. J. Polym. Environ. 2023, 31, 870–885. [Google Scholar] [CrossRef]
- Kimura, T. Multidisciplinary approach for bone metastasis: A review. Cancers 2018, 10, 156. [Google Scholar] [CrossRef] [PubMed]
- Hara, H.; Sakai, Y.; Kawamoto, T.; Fukase, N.; Kawakami, Y.; Takemori, T.; Fujiwara, S.; Kitayama, K.; Yahiro, S.; Miyamoto, T.; et al. Surgical outcomes of metastatic bone tumors in the extremities (Surgical outcomes of bone metastases). J. Bone Oncol. 2021, 27, 100352. [Google Scholar] [CrossRef] [PubMed]
- Miyazaki, K.; Kanda, Y.; Sakai, Y.; Yoshikawa, R.; Yurube, T.; Takeoka, Y.; Hara, H.; Akisue, T.; Kuroda, R.; Kakutani, K. Effect of Bone Metastasis Cancer Board on Spinal Surgery Outcomes: A retrospective study. Medicina 2023, 59, 2087. [Google Scholar] [CrossRef]
- Shinoda, Y.; Sawada, R.; Yoshikawa, F.; Oki, T.; Hirai, T.; Kobayashi, H.; Matsudaira, K.; Oka, H.; Tanaka, S.; Kawano, H.; et al. Factors related to the quality of life in patients with bone metastases. Clin. Exp. Metastasis 2019, 36, 441–448. [Google Scholar] [CrossRef]
- Katagiri, H.; Okada, R.; Takagi, T.; Takahashi, M.; Murata, H.; Harada, H.; Nishimura, T.; Asakura, H.; Ogawa, H. New prognostic factors and scoring system for patients with skeletal metastasis. Cancer Med. 2014, 3, 1359–1367. [Google Scholar] [CrossRef]
- Ratasvuori, M.; Wedin, R.; Keller, J.; Nottrott, M.; Zaikova, O.; Bergh, P.; Kalen, A.; Nilsson, J.; Jonsson, H.; Laitinen, M. Insight opinion to surgically treated metastatic bone disease: Scandinavian Sarcoma Group Skeletal Metastasis Registry report of 1195 operated skeletal metastasis. Surg. Oncol. 2013, 22, 132–138. [Google Scholar] [CrossRef]
- Hansen, B.H.; Keller, J.; Laitinen, M.; Berg, P.; Skjeldal, S.; Trovik, C.; Nilsson, J.; Walloe, A.; Kalén, A.; Wedin, R. The Scandinavian Sarcoma Group skeletal metastasis register: Survival after surgery for bone metastases in the pelvis and extremities. Acta Orthop. Scand. Suppl. 2004, 75, 11–15. [Google Scholar] [CrossRef]
- Ando, M.; Sumitani, M.; Fuyuki, M.; Abe, H.; Shinoda, Y.; Matsubayashi, Y.; Oshima, Y.; Inoue, R.; Tsuchida, R.; Uchida, K. Imaging features inferring symptom onset due to spinal metastasis progression: A preliminary study. Ann. Palliat. Med. 2022, 11, 2247–2256. [Google Scholar] [CrossRef] [PubMed]
- Kakutani, K.; Kanda, Y.; Yurube, T.; Takeoka, Y.; Miyazaki, K.; Ohnishi, H.; Matsuo, T.; Ryu, M.; Kuroshima, K.; Kumagai, N.; et al. The identification of risk factors for symptomatic spinal metastasis onset: A prospective cohort study of 128 asymptomatic spinal metastasis patients. Cancers 2023, 15, 1251. [Google Scholar] [CrossRef] [PubMed]
- Kakutani, K.; Sakai, Y.; Zhang, Z.; Yurube, T.; Takeoka, Y.; Kanda, Y.; Miyazaki, K.; Ohnishi, H.; Matsuo, T.; Ryu, M.; et al. Survival rate after palliative surgery alone for symptomatic spinal metastases: A prospective cohort study. J. Clin. Med. 2022, 11, 6227. [Google Scholar] [CrossRef] [PubMed]
- Kanda, Y.; Kakutani, K.; Sakai, Y.; Yurube, T.; Miyazaki, S.; Takada, T.; Hoshino, Y.; Kuroda, R. Prospective cohort study of surgical outcome for spinal metastases in patients aged 70 years or older. Bone Jt. J. 2020, 102–B, 1709–1716. [Google Scholar] [CrossRef] [PubMed]
- Wheatley-Price, P.; Ali, M.; Balchin, K.; Spencer, J.; Fitzgibbon, E.; Cripps, C. The role of palliative chemotherapy in hospitalized patients. Curr. Oncol. 2014, 21, 187–192. [Google Scholar] [CrossRef] [PubMed]
- Crosara Teixeira, M.; Marques, D.F.; Ferrari, A.C.; Alves, M.F.S.; Alex, A.K.; Sabbaga, J.; Hoff, P.M.; Riechelmann, R.P. The effects of palliative chemotherapy in metastatic colorectal cancer patients with an ECOG performance status of 3 and 4. Clin. Color. Cancer 2015, 14, 52–57. [Google Scholar] [CrossRef] [PubMed]
- Peppercorn, J.M.; Smith, T.J.; Helft, P.R.; Debono, D.J.; Berry, S.R.; Wollins, D.S.; Hayes, D.M.; Roenn, J.H.V.; Schnipper, L.E. American society of clinical oncology statement: Toward individualized care for patients with advanced cancer. J. Clin. Oncol. 2011, 29, 755–760. [Google Scholar] [CrossRef] [PubMed]
- Schnipper, L.E.; Smith, T.J.; Raghavan, D.; Blayney, D.W.; Ganz, P.A.; Mulvey, T.M.; Wollins, D.S. American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: The top five list for oncology. J. Clin. Oncol. 2012, 30, 1715–1724. [Google Scholar] [CrossRef]
- Noronha, V.; Ravind, R.; Patil, V.M.; Mokal, S.; Joshi, A.; Menon, N.; Kapoor, A.; Mahajan, A.; Janu, A.; Nakti, D.; et al. The role of chemotherapy in patients with small cell lung cancer and poor performance status. Acta Oncol. 2020, 59, 1520–1527. [Google Scholar] [CrossRef] [PubMed]
- Kobayashi, M.; Yoshikawa, R.; Harada, R.; Date, A.; Kobayashi, Y.; Kozawa, S.; Sakai, Y. Clinical outcome of patients with bone metastases in a convalescent Rehabilitation Ward: A case series of six patients. PRM 2022, 7, 20220022. [Google Scholar] [CrossRef]
- Vieillard, M.H.; Thureau, S. Multidisciplinary meetings dedicated to bone metastases: A historical perspective and rationale. Bull. Cancer 2013, 100, 1135–1139. [Google Scholar] [CrossRef] [PubMed]
- Morioka, H.; Kawano, H.; Takagi, T.; Abe, S.; Ogata, N.; Iwase, S.; Sakai, Y.; Oshima, K.; Ohe, T.; Nakamura, K. Involvement of orthopaedic surgeons for cancer patients in orthopaedic training facilities certified by the Japanese Orthopaedic Association—A nationwide survey. J. Orthop. Sci. 2023, 28, 446–452. [Google Scholar] [CrossRef] [PubMed]
(a) | ||
Variables | n | Total |
Patients | ||
Age, mean ± SD | 200 | 72.2 ± 12.9 |
Male sex, n (%) | 200 | 116 (58) |
Tumor progression | ||
Primary lesions, as classified by Katagiri, n (%) | 200 | |
Slow growth | 48 (24) | |
Moderate growth | 71 (35.5) | |
Rapid growth | 81 (40.5) | |
Other metastasis, n (%) | 200 | |
No metastasis | 113 (56.5) | |
Visceral/brain metastasis | 77 (38.5) | |
Dissemination | 10 (5.0) | |
Treatment | ||
Rehabilitation | 200 | |
Yes | 69 (34.5) | |
No | 131 (65.5) | |
History of chemotherapy, n (%) | 200 | |
Yes | 118 (59) | |
No | 82 (41) | |
History of radiotherapy, n (%) | 200 | |
Yes | 104 (52) | |
No | 96 (48) | |
Bone-modifying agent | ||
Yes | 79 (39.5) | |
No | 121 (60.5) | |
ADL (activities of daily living) | ||
ECOG-PS, n (%) | 200 | |
0 | 19 (9.5) | |
1 | 71 (35.5) | |
2 | 48 (24) | |
3 | 48 (24) | |
4 | 14 (7) | |
Bone metastasis | ||
Number of bone metastasis, n (%) | 200 | |
1 | 67 (33.5) | |
≥2 | 133 (66.5) | |
Localization of bone metastasis, n (%) | 200 | |
Spine | 177 (88.5) | |
Femur and pelvis | 54 (27) | |
Other | 42 (21) | |
SREs, n (%) | 200 | |
Fracture | 23 (11.5) | |
Spinal cord paralysis | 21 (10.5) | |
Hypercalcemia | 19 (9.5) | |
(b) | ||
Primary Lesion | n | % |
Lung cancer | 47 | 17.3 |
Renal cell cancer | 33 | 12.1 |
Head and neck cancer | 21 | 7.7 |
Breast cancer | 17 | 6.3 |
Hepatocellular carcinoma | 13 | 4.8 |
Prostate cancer | 9 | 3.3 |
Multiple myeloma | 9 | 3.3 |
Gynecological cancer | 8 | 2.9 |
Urothelial cancer | 8 | 2.9 |
Malignant cancer | 6 | 2.2 |
Colon cancer | 5 | 1.8 |
Esophageal cancer | 4 | 1.5 |
Pancreatic cancer | 2 | 0.7 |
Others | 18 | 6.6 |
Initial Assessment | Reassessment | p-Value | |
---|---|---|---|
PS | 1.84 ± 0.08 | 1.72 ± 0.08 | p = 0.065 |
BI | 83.15 ± 1.68 | 84.42 ± 1.73 | p = 0.054 |
EQ-5D | 0.57 ± 0.02 | 0.64 ± 0.02 | p < 0.001 |
NRS max | 5.21 ± 0.24 | 3.56 ± 0.21 | p < 0.001 |
NRS average | 2.98 ± 0.18 | 1.85 ± 0.13 | p < 0.001 |
(a) | |||
Factor | Ia (Increase), n | Da (Decline), n | p-Value |
Age | 72.6 ± 12.6 | 70.9 ± 14.0 | 0.552 |
Sex | 0.473 | ||
Female | 68 | 16 | |
Male | 89 | 27 | |
Rehabilitation | 0.146 | ||
− | 113 | 26 | |
+ | 44 | 17 | |
Primary lesions, as classified by Katagiri | 0.017 | ||
Slow growth | 43 | 5 | |
Moderate growth | 58 | 13 | |
Rapid growth | 56 | 17 | |
Pathological fracture | 0.029 | ||
− | 143 | 34 | |
+ | 14 | 9 | |
Spinal cord paralysis | <0.001 | ||
− | 147 | 32 | |
+ | 10 | 11 | |
Chemotherapy | 0.003 | ||
− | 84 | 34 | |
+ | 73 | 9 | |
Radiotherapy | 0.052 | ||
− | 81 | 15 | |
+ | 76 | 28 | |
Multiple bone metastasis | 0.108 | ||
− | 57 | 10 | |
+ | 100 | 33 | |
Bone-modifying agent | 0.721 | ||
− | 96 | 25 | |
+ | 61 | 18 | |
Change in NRS (Numerical Rating Scale) max score | 0.02 | ||
Improvement | 131 | 29 | |
Deterioration | 26 | 14 | |
Change in NRS average score | 0.004 | ||
Improvement | 134 | 28 | |
Deterioration | 23 | 15 | |
(b) | |||
Factor | OR | 95% CI | p-Value |
Primary lesion classified by Katagiri | 1.731 | 1.049–2.855 | 0.032 |
Spinal cord paralysis | 3.693 | 1.370–9.956 | 0.049 |
Chemotherapy | 0.429 | 0.184–0.998 | 0.02 |
Change of NRS average | 0.378 | 0.166–0.859 | 0.02 |
(a) | |||
Factor | Iq (Increase), n | Dq (Decline), n | p-Value |
Age | 71.8 ± 13.0 | 74.0 ± 12.3 | 0.472 |
Sex | 0.052 | ||
Female | 73 | 11 | |
Male | 88 | 28 | |
Rehabilitation | 0.463 | ||
− | 110 | 29 | |
+ | 51 | 10 | |
Primary lesions, as classified by Katagiri | 0.022 | ||
Slow growth | 45 | 3 | |
Moderate growth | 56 | 15 | |
Rapid growth | 60 | 21 | |
Pathological fracture | <0.001 | ||
− | 149 | 28 | |
+ | 12 | 11 | |
Spinal cord paralysis | <0.001 | ||
− | 153 | 26 | |
+ | 8 | 13 | |
Chemotherapy | <0.001 | ||
− | 85 | 33 | |
+ | 76 | 6 | |
Radiotherapy | 0.092 | ||
− | 82 | 14 | |
+ | 79 | 25 | |
Multiple bone metastasis | 0.246 | ||
− | 57 | 10 | |
+ | 104 | 29 | |
Bone-modifying agent | 0.189 | ||
− | 101 | 20 | |
+ | 60 | 19 | |
Change in NRS max scores | <0.001 | ||
Improvement | 138 | 22 | |
Deterioration | 23 | 17 | |
Change in NRS average scores | <0.001 | ||
Improvement | 142 | 20 | |
Deterioration | 19 | 19 | |
(b) | |||
Factor | OR | 95% CI | p-Value |
Spinal cord paralysis | 8.416 | 2.825–25.072 | <0.001 |
Chemotherapy | 0.249 | 0.091–0.683 | 0.007 |
Change of NRS average | 0.144 | 0.059–0.347 | <0.001 |
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Fujii, Y.; Yoshikawa, R.; Kashima, R.; Saho, W.; Onishi, H.; Matsumoto, T.; Harada, R.; Takeoka, Y.; Sawada, R.; Fukase, N.; et al. Evaluation of Changes in Activities of Daily Living and Quality of Life of Patients with Bone Metastasis Who Underwent Conservative Therapy through Bone Metastasis Cancer Boards. Medicina 2024, 60, 906. https://doi.org/10.3390/medicina60060906
Fujii Y, Yoshikawa R, Kashima R, Saho W, Onishi H, Matsumoto T, Harada R, Takeoka Y, Sawada R, Fukase N, et al. Evaluation of Changes in Activities of Daily Living and Quality of Life of Patients with Bone Metastasis Who Underwent Conservative Therapy through Bone Metastasis Cancer Boards. Medicina. 2024; 60(6):906. https://doi.org/10.3390/medicina60060906
Chicago/Turabian StyleFujii, Yasumitsu, Ryo Yoshikawa, Ryoga Kashima, Wataru Saho, Hirokazu Onishi, Tsuyoshi Matsumoto, Risa Harada, Yoshiki Takeoka, Ryoko Sawada, Naomasa Fukase, and et al. 2024. "Evaluation of Changes in Activities of Daily Living and Quality of Life of Patients with Bone Metastasis Who Underwent Conservative Therapy through Bone Metastasis Cancer Boards" Medicina 60, no. 6: 906. https://doi.org/10.3390/medicina60060906