Bisphosphonate Use in Pediatric Oncology for Pain Management

Doralina L. Anghelescu, Varayini Pankayatselvan, Rosa Nguyen, Deborah Ward, Jianrong Wu, Huiyun Wu, Denaya D. Edwards, Wayne Furman

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

The use of bisphosphonates for pain control in children with cancer is not extensively studied. We retrospectively evaluated 35 children with cancer treated with intravenous bisphosphonates for pain management at a single institution from 1998 through 2015. We analyzed pain scores and opioid and adjuvant medication consumption before bisphosphonate administration, daily for 2 weeks, and at 3 and 4 weeks after administration. We also determined the time interval between diagnosis and first administration of bisphosphonates and duration of life after bisphosphonate administration. Mean pain scores were 2.45 (±2.96) and 0.75 (±1.69) before and 14 days after bisphosphonate administration, respectively (P =.25), and morphine equivalent doses of opioids were 5.52 (±13.35) and 5.27 (±9.77), respectively (P =.07). Opioid consumption was significantly decreased at days 4 to 8, days 11 to 12, and week 3 after first bisphosphonate administration. The median duration of life after first bisphosphonate administration was 80 days, indicating its use late in the course of treatment. Bisphosphonates did not significantly improve pain outcomes at 2 weeks, but opioid consumption was reduced at several time points during the first 3 weeks. The use of bisphosphonates earlier in the course of pediatric oncological disease should be evaluated in prospective investigations.

Original languageEnglish
Pages (from-to)138-142
Number of pages5
JournalAmerican Journal of Hospice and Palliative Medicine
Volume36
Issue number2
DOIs
StatePublished - Feb 1 2019

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the National Cancer Institute Cancer Center Support Core Grant 5P25CA023944 and ALSAC, neither of which had a role in its planning, conduct, analysis, or reporting.

Publisher Copyright:
© The Author(s) 2018.

Keywords

  • adjuvant pain medication
  • bisphosphonate
  • opioid consumption
  • pain management
  • pain scores
  • pediatric cancer

ASJC Scopus subject areas

  • Medicine (all)

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