Patterns and Associated Factors of Breakthrough Pain in Lung Cancer: Insights From a Cross-Sectional Study With Prospective Enrollment.

BACKGROUND: Breakthrough cancer pain (BTcP) is a challenging symptom in lung cancer patients, often associated with poor physical and psychological outcomes. Understanding its clinical features and associated factors is essential for improving pain management and patient care. METHODS: This cross-sectional study prospectively enrolled lung cancer patients with BTcP treated at our center between October 2024 and January 2025. Data were collected through questionnaires and medical records, including demographic, clinical, psychological, and symptom-related variables. Logistic regression analysis was conducted to identify factors associated with BTcP severity. RESULTS: A total of 255 eligible patients were enrolled. BTcP was most commonly located in the chest (148/255, 58.0%) and frequently triggered by coughing (124/255, 48.6%). Most episodes were of short duration and moderate to severe intensity. Multivariate analysis identified treatment modality, cough VAS score, and anxiety level as independent associated factors of BTcP severity (p < 0.05). In the postoperative subgroup (n = 159), surgical extent, number of drain tube, cough VAS score, and anxiety level were significant factors for BTcP severity. CONCLUSIONS: BTcP in lung cancer patients is characterized by high frequency and moderate-to-severe intensity, with anxiety and cough being key contributing factors. Comprehensive pain management should integrate psychological support and symptom control to improve patient outcomes.