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Pegfilgrastim-induced bone pain: incidence, risk factors, and management in a community practice
1 Hematology-Oncology Associates of Central New York Community Clinical Oncology Program (CCOP), East Syracuse, NY; and 2 University of Rochester Cancer Center CCOP Research Base, Rochester, NY
Pegfilgrastim administration has greatly facilitated oncologists’ ability to increase the dose intensity of chemotherapy and has made possible the delivery of dose-dense chemotherapy. Bone pain—the major toxicity of pegfilgrastim—may interfere with patients’ quality of life and may preclude further administration of this growth factor. We surveyed 100 patients following their first dose of pegfilgrastim in a large clinical oncology practice. Of these 100 patients, 41% experienced no bone pain; 35%, moderate pain (score of 1–5 on a scale of 1–10); and 24%, severe pain (6 or greater). The pain occurred between 1 and 2 days after the injection, and the mean durations were 2 and 2.8 days in the moderate and severe pain groups, respectively. Nonsteroidal anti-inflammatory drugs (NSAIDs) were generally effective in relieving moderate pain, but severe pain was often refractory to all analgesia, including the provided narcotics. Age, sex, type of cancer, and treatment were not correlated with the incidence or severity of pain. Our survey suggests that pegfilgrastim-induced pain is a significant problem, is unpredictable, and is often refractory to the administered analgesia.
| Commun Oncol 2007;4:455–459 | full text |  251 kb |