ArticleCancers2018
The Circadian Rhythm of Breakthrough Pain Episodes in Terminally-ill Cancer Patients.
Article in Cancers, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Circadian pain patterns in human pain conditions - A systematic review.Pain practice : the official journal of World Institute of Pain · 2023Pooled it
- The interplay of circadian rhythms and cancer pain: a narrative review.Journal of anesthesia, analgesia and critical care · 2026Review
- A scoping review of breakthrough cancer pain: Multidimensional patient needs and influencing factors.Asia-Pacific journal of oncology nursing · 2025Review
- Circadian attributes of neurological and psychiatric disorders as basis for their medication chronotherapy.Advanced drug delivery reviews · 2025Review
- The Circadian Clock Component REV-ERB Is an Analgesic Target for Cancer-Induced Tactile Pain Hypersensitivity.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2025Article
- Article
- Circadian Rhythms and Pain: A Narrative Review on Clock Genes and Circadian-Based Interventions.Journal of pain research · 2025Review
- How does circadian rhythm affect postoperative pain after pediatric acute appendicitis surgery?Anesthesia and pain medicine · 2024Article
- Suppression of neuropathic pain in the circadian clock-deficientPNAS nexus · 2024Article
- Fentanyl in cancer pain management: avoiding hasty judgments and discerning its potential benefits.Drugs in context · 2023Review
- Retrospective Observational Study on the Characteristics of Pain and Associated Factors of Breakthrough Pain in AdvancedPain research & management · 2022Observational
- Current management of cancer pain in Italy: Expert opinion paper.Open medicine (Warsaw, Poland) · 2022Review
- Circadian rhythms and pain.Neuroscience and biobehavioral reviews · 2021Review
- Characteristics of Breakthrough Pain and Its Impact on Quality of Life in Terminally Ill Cancer Patients.Integrative cancer therapiesObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Opioid therapy must be adjusted to the rhythm of a cancer patient's pain to ensure adequate symptom control at the end of life (EOL). However, to-date no study has explored the rhythm of breakthrough pain (BTP) episodes in terminally-ill cancer patients. This prospective longitudinal study was aimed at verifying the existence of a circadian rhythm of BTP episodes in terminally-ill cancer patients. Consecutive adult cancer patients at their EOL treated with long-acting major opioids to control background pain (Numeric Rating Scale ≤ 3/10) were recruited from two Italian palliative care services. Using a personal diary, patients recorded the frequency and onset of BTP episodes and the analgesic rescue therapy taken for each episode over a 7-day period. Rhythms identified in BTP episodes were validated by Cosinor analysis. Overall, 101 patients were enrolled; nine died during the study period. A total of 665 BTP episodes were recorded (average of 7.2 episodes, mean square error 0.8) per patient, with 80.6% of episodes recorded between 8:00 a.m. and 12:00 a.m. At Cosinor analysis, a circadian rhythm of BTP episodes was observed, with a Midline Estimating Statistics of the Rhythm (MESOR) of 1.5, a double amplitude of 1.8, and an acrophase at 12:30 p.m. (
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.