Clinical, biochemical and radiological profile of bone metstases along with pain score and quality of life in solid malignancies at a tertiary care hospital in North India: Two year prospective study (Preprint)
Authors: Showkat HakimIrfan , Bhat G M , Sarmast Arif , Jan Basharat , Khan Nazir , Robbani Irfan , Azeez Sheikh Aijaz 
Published: December 2019

BACKGROUND

AIM:To study the clinical, biochemical , radioligical profile of bone metastases along with distribution of skeletal metastases with management strategies and effect on quality of life

OBJECTIVE

AIM:To study the clinical, biochemical , radioligical profile of bone metastases along with distribution of skeletal metastases with management strategies and effect on quality of life

METHODS

MATERIAL & METHODS:This is a Two year prospective study from August 2013 to August 2015.Patients with a proven malignancy with bone scan positive metastatic skeletal lesions were taken and the clinical, biochemical & radiological manifestations of were analysed.Pain score by visual analogue score (VAS) both pre-treatment and post treatment were noted. Quality of life was noted at the baseline using European Organization for Research and Treatment of Cancer Quality of Life Group (EORTC) -Q30 questionnaire.

RESULTS

It was observed that majority of patients were males (58.8%).Bone metastases was most common in lung malignancy (30.4%) followed by carcinoma prostate (19.2%). Carcinoma breast was the third most common malignancy (18.8%) and most common malignancy with bone metastases in females. Pain was the most common presentation (83.6%).Alkaline phosphatase was raised in 80 % of cases & lactate Dehydrogenase was high in 92.4%.Osteolytic lesions were seen in 56.4% cases, osteosclerotic/osteoblastic in 32.4% while 11.2% cases had mixed lesions. Target X-ray imaging was positive in 46.8%, computed tomography (CT) scan 86.6%,magnetic resonance imaging (MRI) 81.4%,positron emission tomography (PET/CT) scan 93.3%. Non-Opiod analgesics were commonly used in 83.2% cases followed by Bisphosphonates in 82% .Pain score as per VAS scale improved significantly in all cases of bone metastases post intervention.Quality of life as per EORTC-30 questionnaire was impaired significantly in all cases with 86% cases having moderate to severe impairment.

CONCLUSIONS

It was observed that majority of patients were males (58.8%).Bone metastases was most common in lung malignancy (30.4%) followed by carcinoma prostate (19.2%). Carcinoma breast was the third most common malignancy (18.8%) and most common malignancy with bone metastases in females. Pain was the most common presentation (83.6%).Alkaline phosphatase was raised in 80 % of cases & lactate Dehydrogenase was high in 92.4%.Osteolytic lesions were seen in 56.4% cases, osteosclerotic/osteoblastic in 32.4% while 11.2% cases had mixed lesions. Target X-ray imaging was positive in 46.8%, computed tomography (CT) scan 86.6%,magnetic resonance imaging (MRI) 81.4%,positron emission tomography (PET/CT) scan 93.3%. Non-Opiod analgesics were commonly used in 83.2% cases followed by Bisphosphonates in 82% .Pain score as per VAS scale improved significantly in all cases of bone metastases post intervention.Quality of life as per EORTC-30 questionnaire was impaired significantly in all cases with 86% cases having moderate to severe impairment.