The difference between the subjective and objective evaluation of oxaliplatin-induced vascular pain due to administer chemotherapy via peripheral vein.

Abstract

651 Background: We have reported the safety and effectiveness of chemotherapy via median cubital vein for metastatic colorectal cancer without implantation of a central venous port. However, vascular pain (VP) occasionally requires switching of the drip infusion route during chemotherapy for the administration of oxaliplatin via the peripheral vein. VP and phlebitis induced by intravenous infusion of antineoplastic agents reduces the rate of completion or continuation of chemotherapy. We also reported that addition of dexamethasone to oxaliplatin drip infusion controlled the vascular pain caused by administration of oxaliplatin via the peripheral vein (ASCO-GI2012). Pain is currently evaluated using subjective methods such as the visual analog scale (VAS). However, because the assessment of pain can greatly vary depending on the mood and physical state of the patient at the time of assessment, it is best to objectively evaluate pain. Pain Vision PS-2100 (PV) is an analytical instrument that was designed to quantitatively and objectively assess sense perception and nociception in a patient. Although it is used in the field of anesthesiology, there have been no reports concerning it for the assessment of oxaliplatin-induced VP. Methods: The present study examined the correlation of subjective and objective assessment results using VAS and PV, respectively, for cases of oxaliplatin-induced VP. Subjects comprised 57 patients with colorectal cancer who underwent chemotherapy at the Fukuoka University. Results: Both VAS and PV assessments of PN were performed 162 times in total, and partial correlation coefficient analysis adjusted by subject and gender. The VAS and PV mean values of VP were 24.8 (0–100) and 44.5 (0–596), respectively. The partial correlation coefficient was 0.350 (p= 0.0002). Conclusions: Although both assessments evaluated the same events, no strong correlation was observed between the results and a weak correlation was observed between VAS and PV. These results suggest that because VAS and PV each measure different factors, both subjective and objective assessments of drugs designed to ameliorate oxaliplatin-induced VP are necessary.