Abstract
Objectives: To describe the incidence and characteristics of paclitaxel induced acute pain syndrome and asses the change in pain related to paclitaxel dose and number of cycle.
Methods: The Study was prospective in which we included the eligible patients scheduled to receive paclitaxel weekly or 3 weekly; alone or in combination with another chemotherapeutic agent Carboplatin. Details regarding acute Pain were collected and evaluated.
Results: Majority of patient who developed P-APS, received combination of chemotherapy as compared to patients who received chemoradiation or paclitaxel alone. The P-APS was measured on the basis of scoring provided by LANSS pain scale, majority of patients had pain score of less than 12. As far as nature of pain was concerned, we found that the commonest complaints were pinpricking (34.29%) and dull (22.8%) rather than burning (14%), numbness experienced in the knees(44%) followed by in lower limbs (24%), hand (15%), feet(8%), and 4% in ankle.
Conclusion: The incidence and characteristics of pain is related to paclitaxel dose and number of cycles. Subsequent cycles of paclitaxel are having no effect on intensity of pain syndrome. Duration of pain increases if patients receive combination of Paclitaxel and carboplatin. Addition of radiation is having neither synergistic nor protective effect in our study.
References
- Bissery M-C, Nohynek G, Sanderlink G-J, Lavelle F. 1995. Docetaxel (Taxotereâ): a review of preclinical and clinical experience. Part Preclinical experience. Anti- Cancer Drugs 6:339–55.
- Kearns CM, Gianni L, Egorin MJ. 1995.Paclitaxel pharmacokinetics and pharmacodynamics. Oncol. 22(Suppl. 6):16–23.
- Rowinsky EK, Eisenhauer EA, Chaudhry V, Arbuck SG, Donehower RC. Clinical toxicities encountered with paclitaxel (Taxol). Semin Oncol. 1993;20:1–15.
- Garrison JA, McCune JS, Livingston RB, Linden HM, Gralow JR, Ellis GK, et al. Myalgias and arthralgias associated with paclitaxel. Oncology (Willisto Park). 2003;17:271–7. Discussion 281–272, 286–278.
- Reeves BN, Dakhil SR, Sloan JA, Wolf SL, Burger KN, Kamal A, et al. Further data supporting that paclitaxel-associated acute pain syndrome is associated with development of peripheral neuropathy: North Central Cancer Treatment Group trial N08C1 Cancer.2012;118:5171–8.
- Loprinzi CL, Reeves BN, Dakhil SR, Sloan JA, Wolf SL, Burger KN, et al. Natura history of paclitaxel-associated acute pain syndrome: prospective cohort study NCCTG N08C1. J Clin Oncol. 2011;29:1472–8.
- Rowinsky EK, ChaudhryV, Cornblath DR, Donehower RC. 1993. The neurotoxicty oftaxol. Natl Cancer Inst. 15:107– 15.
- Chaudhry V, Rowinsky EK, Sartorius SE, et al. 1994. Peripheral neuropathy from taxol and cisplatin combination chemotherapy: clinical and electrophysio-logical studies. Neurol. 35:490–97.
- Moulder SL, Holmes FA, Tolcher AW, et al: A randomized phase 2 trial comparing 3-hour versus 96-hour infusion schedules of paclitaxel for the treatment of metastatic breast cancer. Cancer 116: 814-821, 2010.
- Slater M S, Holland J, Faigel D O, Sheppard B C, Deveney CW. Does neo-adjuvant chemoradiation downstage esophageal carcinoma? Am J Surg 2001; 181: 440–4.
- Choy H, Akerley W, Safran H et al. Multi institutional phase II trial of paclitaxel, carboplatin, and concurrent radiation therapy for locally advanced non-small-cell lung cancer. J Clin Oncol1998; 16: 3316–22.
- MA Wani, FA Jan, NA Khan. Cancer trends in Kashmir; common types, site incidence and demographic profiles: National Cancer Registry 2000-2012. Indian J Cancer [serial online] 2014 [cited 2016 Jun 21];51:133-7.
- Bennett M, The LANSS Pain Scale: The leed Assessment o neuropathic symptoms and sign Pain 2001;92: 147-157.
Corresponding Author
Dar Abdul Waheed
DOI: https://dx.doi.org/10.18535/jmscr/v6i9.157
