SynthesisFrontiers in oncology2026
Global burden of pain in malignant bone tumors: a meta-analysis of severity and health outcomes.
Synthesis in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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6 authors.
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Abstract
Background: Malignant bone tumors are one of the most painful types of cancer, and their pain is very difficult to manage. Pain-relieving methods such as radiotherapy, Bone-Modifying Agents (BMAs), and radiopharmaceuticals have been explored in different studies and found to be effective pain control measures and also prevention of skeletal-related events (SREs). This meta-analysis analyzes the global burden of pain in malignant bone tumors with an emphasis on severity, health outcomes, and the efficacy of pain management interventions. Methods: Nineteen randomized controlled trials and comparative studies were selected, which included patients with Malignant Bone Tumors. Treatments involved External Beam Radiotherapy (EBRT) in single or multi-fractions, BMAs (zoledronic acid, ibandronate, pamidronate, denosumab), and radiopharmaceuticals (Radium-223, Strontium-89, Samarium-153) either alone or in combination. Random-effects models were used to compute standardized mean differences (SMDs), with the evaluation of heterogeneity, Jadad score, and GRADE quality. Results: Interventions across all subgroups were effective at relieving pain and protecting bones. One-time EBRT was shown to be as effective as standard multi-fraction treatments (SMD 0.04, 95% CI -0.02-0.1) for pain management. BMA-based treatments yielded contradictory results: denosumab versus zoledronic acid did not show a significant difference (SMD 0.01, 95% CI -0.02-0.05), whereas bisphosphonates alone resulted in a significant uplift (SMD 0.12, 95% CI 0.05-0.2, p<0.05). Short-course radiotherapy (≤1 week) also exhibited a positive but negligible impact (SMD 0.05, 95% CI 0.05-0.05, p<0.05). The variance in results was minimal, and the majority of the studies were classified as fair to good quality according to the Jadad and GRADE evaluations. Conclusions: Radiotherapy, BMAs, and radiopharmaceuticals, either singly or in tandem, are well-tolerated for managing pain and preventing SREs in patients with malignant bone tumors, thereby providing patients with various ways to enhance their quality of life.
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