Dexamethasone for the Prophylaxis of Pain Flare Study

Study Overview
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Brief Summary
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Radiation treatment is often recommended as a safe and quick treatment that gives most people good relief from bone pain within a couple of weeks. However, some people can experience a short episode of increased pain (called a 'flare') a day or two after radiation treatment, that lasts about a day. The purpose of this sturdy is to find out if a medication called dexamethasone can help prevent pain flare as a result of radiation therapy.

Detailed Description
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Of all people diagnosed with cancer, 25% will have their cancer come back and spread to the bones. This often results in significant pain and suffering. Radiation treatment is often recommended as a safe and quick treatment that gives most people good relief from bone pain within a couple of weeks. However, some people can experience a short episode of increased pain called a flare a day or two after radiation treatment that lasts about a day. Studies suggest that around a third of all people who receive radiation treatment to help pain from cancer in the bones will have a pain flare. This study is being done because it would be helpful to prevent extra bone pain from happening to people after they receive radiation treatments. The purpose of this study is to find out if a medication called dexamethasone can help prevent pain flare as a result of radiation therapy.

Official Title
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Dexamethasone for the Prophylaxis of Radiation-Induced Pain Flare Following Palliative Radiotherapy for Bone Metastases

Conditions
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Cancer

Intervention / Treatment
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* Drug: dexamethasone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Documented bone metastases by radiological imaging Patients at least 18 years of age Written consent KPS ≥ 40 Baseline worst pain at the planned radiated bony metastatic site ≥ 2 Patient able to inform the pain score at the planned radiated bony metastatic site Exclusion Criteria: Concurrent use of any corticosteroid medication other than topical or inhaled preparations Medical contraindications to corticosteroids such as diabetes mellitus, uncontrolled hypertension or active peptic ulcer Pathological fracture of the irradiated extremity Spinal cord compression Language barrier Immediate change in regular analgesic medication. If the oncologist thinks the patient is not receiving adequate analgesic, we recommend the oncologist to increase the analgesic first to stabilize ot lessen the pain before recruiting the patient to this study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dexamethasone<br>8mg Dexamethasone PO on days 0 (prior to radiation treatment), and days 1, 2, and 3 following radiation treatment. | Drug: dexamethasone<br>* 8mg Dexamethasone PO on days 0 (prior to radiation treatment), and days 1, 2, and 3 following radiation treatment.<br>* Other names: Decadron;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complete control of pain flare on days 1-5 after the completion of radiation treatment. |  | Days 1-5 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complete control of pain flare from Day 6-10 after the completion of radiation treatment. |  | Days 6-10 | 
| Functional interference especially mood and sleep in Brief Pain Inventory will be monitored. |  | Days 0, 1-10, and 6-weeks from baseline assessment | 
| Quality of life outcomes |  | Baseline and 6-weeks following treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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radiation therapy, palliative, pain