Comprehensive pain management was associated with superior pain control, better quality of life, and improved psychological outcomes in advanced cancer compared to standard analgesia, alongside reduced opioid escalation.
Key Findings
Results
Multimodal therapy was associated with superior pain control at two weeks compared to pharmacotherapy alone.
NRS scores at 2 weeks were 2.8 ± 1.1 in the comprehensive management group versus 4.2 ± 1.3 in the pharmacotherapy-only group (P < 0.05)
Pain response rates were 58.3% in the multimodal arm versus 35.0% in the standard arm (P < 0.05)
Undertreated cases were fewer in the comprehensive group: 16.7% vs 41.7% (P < 0.05)
Comprehensive management included standard analgesics plus ≥1 adjunct modality: interventional oncology, thermotherapy, psychological counseling, or palliative support
Results
Comprehensive pain management was associated with better functional capacity and lower symptom burden.
Functional capacity scores (EORTC QLQ-C30) were 68.5 ± 12.4 in the comprehensive group versus 55.3 ± 13.6 in the pharmacotherapy-only group (P < 0.001)
Symptom burden scores were lower in the comprehensive group: 25.6 ± 8.9 versus 38.4 ± 11.2 (P < 0.001)
Outcomes were measured at baseline and two weeks post-intervention
Results
Comprehensive pain management was associated with lower anxiety and depression scores compared to standard pharmacotherapy.
Anxiety scores (HADS) were 6.2 ± 2.8 in the comprehensive group versus 9.5 ± 3.1 in the pharmacotherapy-only group (P < 0.001)
Depression scores (HADS) were 5.8 ± 2.5 in the comprehensive group versus 8.9 ± 3.0 in the pharmacotherapy-only group (P < 0.001)
Both anxiety and depression were assessed using the Hospital Anxiety and Depression Scale at two weeks
Results
Opioid escalation was significantly attenuated in the multimodal treatment arm.
Opioid escalation rates were 47.26% in the comprehensive management group versus 65.27% in the pharmacotherapy-alone group (P < 0.001)
Adverse event rates were similar between the two groups (P > 0.05)
The authors note this finding 'may have clinical relevance for reducing opioid-related adverse events'
Methods
Propensity score matching successfully balanced the two groups from an initial sample of 150 patients.
Standardized mean differences after matching were < 0.1, indicating good balance
Matching balanced demographics, disease status, and baseline pain severity
The study was a retrospective design covering the period 2022–2025
Results
Regression analyses identified comprehensive care as an independent correlate of better outcomes, with sensitivity analyses confirming robustness.
Regression modeling identified comprehensive pain management as an independent correlate of better pain, quality-of-life, and psychological outcomes
Sensitivity analyses confirmed the robustness of these associations
Primary endpoints included NRS, Pain Management Index, EORTC QLQ-C30, and HADS
What This Means
This research suggests that advanced cancer patients who received a comprehensive approach to pain management — combining standard pain medications with at least one additional treatment such as interventional procedures, heat therapy, psychological counseling, or palliative support — had meaningfully better outcomes than those who received medication alone. After two weeks, patients in the comprehensive care group reported lower pain scores, were more likely to have their pain adequately controlled, and had fewer cases of undertreated pain. They also reported better ability to function in daily life, a lower burden from cancer-related symptoms, and notably lower levels of anxiety and depression.
A particularly notable finding was that patients receiving comprehensive care needed smaller increases in opioid doses over the two-week period (about 47% required dose escalation compared to about 65% in the medication-only group), while rates of side effects were similar between the two groups. This suggests that adding non-medication-based treatments may help manage pain effectively without requiring as much opioid dose increases, which could potentially reduce the risk of opioid-related harms.
This study used propensity score matching — a statistical technique designed to make the two groups of patients as similar as possible before comparing them — to reduce bias in this retrospective (looking back at existing records) study. While this method improves comparability, it cannot fully replace a randomized controlled trial. The findings support the potential value of integrating multiple treatment strategies into cancer pain care and point to broader benefits for patients' mental health and overall quality of life, not just pain relief.
Lei W, Gao Y, Yuan W, Wang Q, Deng Z. (2026). Comprehensive Pain Management, Quality of Life, and Mental Health in Advanced Cancer: A Propensity Score-Matched Retrospective Study.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/71629