Background and objective: Typical endpoints in cancer clinical trials focus on standardized efficacy endpoints, such as overall survival. Pain is not always assessed, although it is a highly prevalent and distressing aspect of patients’ cancer experience and plays a critical role in health-related quality of life. To inform future pain measurement strategies in oncology, this targeted literature review of pain-related qualitative publications in oncology aimed to characterize and explore the patient experience of pain, and its impact on how patients feel and function. Methods: A review of publications in MEDLINE, Embase and PsycINFO from 2018 to 2023 was conducted. Patient quotes or author descriptions/interpretations were extracted and analyzed with directed content analysis techniques, using ATLAS.ti v9. Data were synthesized to inform the development of a conceptual model. Results: Twenty-eight publications, with data from 534 patients across different oncology indications and geographies, were reviewed. Pain was triggered by disease symptoms and treatment, including surgical procedures, chemotherapy, and radiation. Pain was most often daily, severe, and chronic in nature. Characterizations of pain varied, but most often “sharp”/“stabbing”/“shooting” pain was described across different treatment stages. Pain had an extensive impact on emotional wellbeing, activities of daily living, physical, physiological and social functioning, sleep and work. Unmet needs included difficulty communicating pain needs to healthcare practitioners and fear/distrust of opioid pain medication. Conclusions: This research provides a patient-centric model conceptualizing the patient experience of cancer-related pain. The findings highlight the burden and all-encompassing impact of cancer-related pain, demonstrating the importance of assessing pain in oncology clinical trials.
背景与目的：癌症临床试验的典型终点通常聚焦于标准化疗效指标，如总生存期。尽管疼痛是癌症患者经历中极为普遍且痛苦的症状，并对健康相关生活质量具有关键影响，却未得到常规评估。为优化肿瘤学领域的疼痛评估策略，本研究通过针对性文献综述，系统梳理肿瘤学疼痛相关质性研究，旨在深入解析患者对疼痛的体验及其对患者感受与功能状态的影响。方法：检索2018年至2023年间MEDLINE、Embase及PsycINFO数据库收录的文献。采用定向内容分析法，借助ATLAS.ti v9软件提取并分析患者直接陈述与作者描述/阐释内容，通过数据整合构建概念模型。结果：共纳入28篇文献，涵盖534例来自不同瘤种及地域的患者数据。疼痛主要由疾病症状及治疗（包括外科手术、化疗与放疗）引发，多表现为持续性、重度、慢性疼痛。疼痛特征描述存在差异，但"锐痛"/"刺痛"/"放射痛"在不同治疗阶段最为常见。疼痛对情绪状态、日常生活活动、生理机能、社会功能、睡眠及工作均产生广泛影响。未满足的需求包括向医疗人员准确传达疼痛诉求存在困难，以及对阿片类镇痛药物的恐惧/不信任。结论：本研究构建了以患者为中心的癌症相关疼痛体验概念模型，揭示了癌症相关疼痛的多维负担与全面影响，论证了在肿瘤学临床试验中系统评估疼痛的重要性。
肿瘤(癌症)患者之家