To analyze the global burden of pain in malignant bone tumors, focusing on severity, health outcomes, and the efficacy of pain management interventions.
Approach:
Study Selection: Nineteen randomized controlled trials and comparative studies were selected involving patients with malignant bone tumors.
Intervention Types: Treatments included External Beam Radiotherapy (EBRT), Bone-Modifying Agents (BMAs), and radiopharmaceuticals, either alone or in combination.
Analysis Method: Random-effects models were used to compute standardized mean differences (SMDs), evaluating heterogeneity and study quality.
Key Findings:
All interventions effectively relieved pain and protected bones.
One-time EBRT was as effective as multi-fraction treatments (SMD 0.04, 95% CI -0.02–0.1).
Denosumab and zoledronic acid showed no significant difference (SMD 0.01, 95% CI -0.02–0.05).
Bisphosphonates alone resulted in a significant uplift (SMD 0.12, 95% CI 0.05–0.2, p<0.05).
Short-course radiotherapy had a positive but negligible impact (SMD 0.05, 95% CI 0.05–0.05, p<0.05).
Interpretation:
Radiotherapy, BMAs, and radiopharmaceuticals are well-tolerated for managing pain and preventing skeletal-related events in patients with malignant bone tumors.
Limitations:
Variability in trial designs and treatment protocols.
Limited direct comparisons across studies due to different outcome measures.
Conclusion:
The meta-analysis provides a comprehensive overview of pain management strategies for malignant bone tumors, highlighting effective interventions.
