Bisphosphonate Use in Pediatric Oncology for Pain Management.
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.
['Anghelescu|Doralina L|DL|http://orcid.org/0000-0002-8521-2744', 'Pankayatselvan|Varayini|V|', 'Nguyen|Rosa|R|', 'Ward|Deborah|D|', 'Wu|Jianrong|J|', 'Wu|Huiyun|H|', 'Edwards|Denaya D|DD|', 'Furman|Wayne|W|']
D000284:Administration, Oral D000293:Adolescent D000367:Age Factors D017668:Age of Onset D000701:Analgesics, Opioid D001859:Bone Neoplasms D000072716:Cancer Pain D002648:Child D002675:Child, Preschool D004164:Diphosphonates D005260:Female D000077206:Gabapentin D006801:Humans D008297:Male D059408:Pain Management D010147:Pain Measurement D044469:Racial Groups D012737:Sex Factors D013997:Time Factors D055815:Young Adult
bisphosphonate pain management pain scores opioid consumption adjuvant pain medication pediatric cancer