Introduction
The Brazilian National Cancer Institute (INCA) estimated that cancer incidences in Brazil for 2020 - 2022 will be 685,960 new patients and 8,460 will be in children and adolescents 1. Of this small population, 5% are bone cancers cases, osteosarcomas (OS) and Ewing sarcomas (ES) 1,2. Pain is the symptom most prevalent in these types of cancer which is estimated to be present in about 75% to 90% of patients with advanced cancer3–9 and can be present from the moment of the diagnosis to the end-of-life 10–12.
With advances in pediatric bone cancer treatment, especially the use of intensive combination chemotherapies and supportive care, pediatric bone cancer death rates have been declining 13. However, pain continues to be the most prevalent symptom in this population, and it has an important role in their quality of life14,15, especially in patients with advanced disease and in end-of-life period.
Although there are many pain management guidelines, as World Health Organization (WHO) and Expert Working Group of European Association for the Palliative Care. Pain undertreatment is still a problem and represent 40% of patients with advanced cancer16–18, one of the reasons for this untreated pain is the inappropriate use of opioids 19.
This study had the objective to evaluate pain management in pediatric patients with bone tumors during treatment and follow up and to investigate if there was difference in pain status at last evaluation between those on treatment or in disease control and those at the end-of-life.