Doralina L. Anghelescu1, Varayini Pankayatselvan1, Rosa Nguyen1, Deborah Ward1, Jianrong Wu1
1) United States
Background and Aims: The use of bisphosphonates, specifically for pain control in pediatric patients with bone cancer is not well studied. To explore the analgesic effects of bisphosphonates in children, we analyzed pain outcomes in patients with primary or secondary bone cancer treated intravenously with bisphosphonates (zoledronate and/or pamidronate).
Methods: We retrospectively evaluated the pain outcomes of 37 pediatric patients who were treated with bisphosphonates at our institution from 1998 through 2015. Pain outcomes included pain scores and opioid or adjuvant medication consumption, analyzed before bisphosphonate administration, and daily for 2 weeks after bisphosphonate administration. Opioid consumption was calculated from the daily morphine equivalent dose of intravenously administered opioids. We also determined the median duration of life of each patient after bisphosphonate administration.
Results: The mean pain scores were 2.45 (± 2.96) and 0.75 (± 1.69) and the morphine equivalent dose of opioids were 5.52 (± 13.35) and 5.27 (± 9.77) (p=0.065) before and 14 days after bisphosphonate administration; the differences were not statistically significant. The median duration of life after administration of the first bisphosphonate dose was 80 days, indicating late use in the course of treatment.
Conclusions: Bisphosphonates did not appear to improve pain outcomes, possibly due to the late use of bisphosphonates in the course of treatment, when high doses of opioids may mask any analgesic effects
