{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:13Z","timestamp":1787028673438,"version":"build-2736575974"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T00:00:00Z","timestamp":1585785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006259","name":"Teva Pharmaceutical Industries","doi-asserted-by":"publisher","award":["C25608-CNS-40076"],"award-info":[{"award-number":["C25608-CNS-40076"]}],"id":[{"id":"10.13039\/100006259","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: To explore the effect of breakthrough cancer pain (BTcP) treatment on quality of sleep and other aspects of the health-related quality of life (HRQoL) in patients with cancer pain. Methods: In an observational, multicenter, cohort study, cancer patients from palliative care units, oncology departments, and pain clinics and affected by BTcP were included. Enrolled patients were assessed at the four visits: T0 (baseline), T7, T14, and T28. Stable chronic background pain (numeric rating scale, NRS \u2264 4) during the whole study period was mandatory. BTcP was treated through transmucosal fentanyl. Three questionnaires were used to measure the HRQoL: EORTC QLQ-C15-PAL, Pittsburgh Sleep Quality Index (PSQI), and the Edmonton Symptom Assessment System (ESAS). RESULTS: In 154 patients, the HRQoL showed a significant improvement for all physical and emotional characteristics in the EORTC QLQ-C15-PAL, except for nausea and vomiting (linear p-value = 0.1) and dyspnea (Linear p-value = 0.05). The ESAS and PSQI questionnaires confirmed these positive results (p &lt; 0.0001 and p = 0.002, respectively). Conclusions: This prospective investigation by an Italian expert group, has confirmed that careful management of BTcP induces a paramount improvement on the HRQoL. Because in cancer patients there is a high prevalence of BTcP and this severe acute pain has deleterious consequences, this information can have an important clinical significance.<\/jats:p>","DOI":"10.3390\/jcm9041003","type":"journal-article","created":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T13:39:34Z","timestamp":1585834774000},"page":"1003","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Careful Breakthrough Cancer Pain Treatment through Rapid-Onset Transmucosal Fentanyl Improves the Quality of Life in Cancer Patients: Results from the BEST Multicenter Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Arturo","family":"Cuomo","sequence":"first","affiliation":[{"name":"Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS. Fondazione G. Pascale, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5236-3132","authenticated-orcid":false,"given":"Marco","family":"Cascella","sequence":"additional","affiliation":[{"name":"Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS. Fondazione G. Pascale, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cira Antonietta","family":"Forte","sequence":"additional","affiliation":[{"name":"Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS. Fondazione G. Pascale, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5408-9675","authenticated-orcid":false,"given":"Sabrina","family":"Bimonte","sequence":"additional","affiliation":[{"name":"Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS. Fondazione G. Pascale, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Esposito","sequence":"additional","affiliation":[{"name":"Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS. Fondazione G. Pascale, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0926-6302","authenticated-orcid":false,"given":"Stefano","family":"De Santis","sequence":"additional","affiliation":[{"name":"Palliative Care and Oncologic Pain Service, S. Camillo-Forlanini Hospital, 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0303-3778","authenticated-orcid":false,"given":"Luigi","family":"Cavanna","sequence":"additional","affiliation":[{"name":"Department of Oncology-Hematology, G. da Saliceto Hospital, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Fusco","sequence":"additional","affiliation":[{"name":"Palliative Home Care Unit, ASL 3, 16153 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5592-783X","authenticated-orcid":false,"given":"Mario","family":"Dauri","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Resuscitation, II University of Rome, Tor Vergata, 00133 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3758-5375","authenticated-orcid":false,"given":"Silvia","family":"Natoli","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Resuscitation, II University of Rome, Tor Vergata, 00133 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Maltoni","sequence":"additional","affiliation":[{"name":"Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Morabito","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, Istituto Nazionale Tumori, IRCCS. Fondazione G. Pascale, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco Domenico","family":"Mediati","sequence":"additional","affiliation":[{"name":"Palliative Care and Pain Therapy Unit, University Hospital Careggi, 50134 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Lorusso","sequence":"additional","affiliation":[{"name":"UO Oncologia Medica, Istituto Tumori \u201cG Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Barni","sequence":"additional","affiliation":[{"name":"Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giampiero","family":"Porzio","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, San Salvatore Hospital, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiano","family":"Mercadante","sequence":"additional","affiliation":[{"name":"Main regional center for Pain Relief &amp; Supportive Care, La Maddalena Cancer Center, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-3328","authenticated-orcid":false,"given":"Anna","family":"Crispo","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS. Fondazione G. Pascale, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.jpainsymman.2015.12.340","article-title":"Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis","volume":"51","author":"Hochstenbach","year":"2016","journal-title":"J. Pain Symptom Manag."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.3322\/caac.21453","article-title":"Optimal pain management for patients with cancer in the modern era","volume":"68","author":"Scarborough","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"iv166","DOI":"10.1093\/annonc\/mdy152","article-title":"ESMO Guidelines Committee. 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