TY - JOUR
T1 - Bisphosphonate Use in Pediatric Oncology for Pain Management
AU - Anghelescu, Doralina L.
AU - Pankayatselvan, Varayini
AU - Nguyen, Rosa
AU - Ward, Deborah
AU - Wu, Jianrong
AU - Wu, Huiyun
AU - Edwards, Denaya D.
AU - Furman, Wayne
N1 - Publisher Copyright:
© The Author(s) 2018.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - 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.
AB - 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.
KW - adjuvant pain medication
KW - bisphosphonate
KW - opioid consumption
KW - pain management
KW - pain scores
KW - pediatric cancer
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U2 - 10.1177/1049909118793114
DO - 10.1177/1049909118793114
M3 - Article
C2 - 30114925
AN - SCOPUS:85052576902
SN - 1049-9091
VL - 36
SP - 138
EP - 142
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
IS - 2
ER -