title: Treatment of vinorelbine-associated tumor pain.
abstract: Vinorelbine is a synthetic vinca alkaloid used for the treatment of Hodgkin's disease and metastatic breast, non-small-cell lung, and ovarian cancers. Vinorelbine-associated tumor pain can be so severe that patients are unable to complete therapy. We present a series of three patients who were premedicated with ketorolac in an attempt to control infusion-related pain. Two of our patients responded well and were able to complete their courses of vinorelbine therapy. The third had persistently severe pain, and therapy was terminated because of pain and lack of response to vinorelbine treatment. These three cases support the hypothesis that surgery or radiation therapy before the use of vinorelbine may increase the likelihood of experiencing associated tumor pain. Premedication with ketorolac and morphine before vinorelbine infusion is proposed as a reasonable prophylactic treatment for associated tumor pain.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, The University of Kansas Medical Center, Kansas City, Kansas 66160-7341, USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Long
authors.forename: R K
authors.initials: RK
authors.lastname: Twillman
authors.forename: T A
authors.initials: TA
authors.lastname: Cathers-Schiffman
authors.forename: T
authors.initials: T
authors.lastname: O'Donnell
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D020910:Ketorolac / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced* / Q000517:prevention & control*; D014747:Vinblastine / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077235:Vinorelbine
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000972:Antineoplastic Agents, Phytogenic; D014747:Vinblastine; D000077235:Vinorelbine; D020910:Ketorolac