Risk factors for bone metastasis in lung cancer and the efficacy of palliative radiotherapy and opioid analgesics in alleviating bone metastasis pain

Zhang,Qinzhi; Qu,Bo; Fan,Jiazhen; Liu,Chunyu; Shan,Bin; Chen,Chunrong; Gao,Yue

doi:10.3892/ol.2025.15175

Risk factors for bone metastasis in lung cancer and the efficacy of palliative radiotherapy and opioid analgesics in alleviating bone metastasis pain

Authors:
- Qinzhi Zhang
- Bo Qu
- Jiazhen Fan
- Chunyu Liu
- Bin Shan
- Chunrong Chen
- Yue Gao
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Affiliations: Department of Radiotherapy, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China, Department of Radiochemotherapy, Qiqihar First Hospital, Qiqihar, Heilongjiang 161000, P.R. China
Published online on: July 7, 2025 https://doi.org/10.3892/ol.2025.15175
Article Number: 429
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Bone metastasis is a severe complication in advanced lung cancer, which notably affects the quality of life and prognosis in patients. The present study investigated risk factors for bone metastasis and evaluated the effects of radiotherapy and opioids on bone metastasis‑related pain. Clinical data from 200 patients with lung cancer (100 with and 100 without bone metastasis) were retrospectively analyzed. Risk factors were identified using logistic regression analyses and a predictive model was validated with receiver operating characteristic curve and decision curve analyses. Pain relief from radiotherapy, opioids and combined therapy was assessed using visual analog scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) scores. Larger tumor diameter, respiratory symptoms, EGFR mutations (85 vs. 35%; P<0.001) and elevated serum markers (including carcinoembryonic antigen, neuron‑specific enolase and alkaline phosphatase, all P<0.001; and CA199, P=0.043) were significant risk factors for bone metastasis. The predictive model achieved an area under the curve value of 0.996, which demonstrated enhanced accuracy and clinical utility. Combined therapy provided improved pain relief, and markedly improved VAS and PSQI scores compared with monotherapy. Key risk factors for bone metastasis were identified and a robust predictive model was established. Combined radiotherapy and opioids effectively manage bone metastasis pain and potentially offer novel insights for early detection and treatment strategies in the future.

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