Risk Factors for Gemcitabine-Induced Vascular Pain in Patients With Pancreatic Cancer

• Published in: The Annals of pharmacotherapy 2021-06, Vol.55 (6), p.738-744
• Main Authors: Ishida, Shigeru, Makihara, Yoko, Watanabe, Hiroyuki, Nakashima, Takafumi, Nagata, Kenichiro, Suetsugu, Kimitaka, Tsuji, Toshikazu, Hata, Kojiro, Ikeda, Munehiko, Ikebe, Mio, Minami, Haruna, Watanabe, Hitomi, Nakata, Kohei, Nakamura, Masafumi, Egashira, Nobuaki, Ieiri, Ichiro
• Format: Article
• Language: English
• ISSN: 1060-0280; 1542-6270
• DOI: 10.1177/1060028020969354

Background: Peripheral intravenous injection of gemcitabine often causes vascular pain; however, preventive measures have not yet been established. Objectives: This study focused on identifying predictive factors for gemcitabine-induced vascular pain. Methods: We retrospectively analyzed risk factors for developing vascular pain in patients with pancreatic cancer receiving gemcitabine infusions at our institution. Infusions were divided into groups according to presence or absence of vascular pain symptoms, and variables were compared. Odds ratios for risk factors were calculated using logistic regression analyses. Results: Overall, 272 patients with pancreatic cancer were subjected to 725 gemcitabine infusions, and of these, 18.4% (n = 50) experienced vascular pain. There were significant differences in the gemcitabine dose (P = 0.025), dose of gemcitabine/body surface area (BSA; P = 0.004), concentration of gemcitabine (P = 0.025), and hot pack use (P = 0.011) between the vascular pain and no vascular pain groups. Multivariable analyses indicated that gemcitabine dose/BSA and lack of hot pack use were risk factors for developing vascular pain. Moreover, on administration of a higher dosage (>930 mg/m2), the incidence of vascular pain in patients using a hot pack (6.7%) was significantly lower than that in patients not provided a hot pack (16.2%). Conclusions and Relevance: High gemcitabine dosages and lack of hot pack use were predictive factors for gemcitabine-induced vascular pain in patients with pancreatic cancer. Patients receiving gemcitabine treatment should apply a hot pack to the injection site. Scrupulous clinical attention is required for patients presenting with these risk factors to improve pain management.