A comparative prospective Study of Paclitaxel Induced Acute Pain syndrome, single agent paclitaxel compared to combination of paclitaxel and carboplatin

Objectives: To describe the incidence and characteristics of Paclitaxel induced acute pain syndrome. To assess the change in pain (i.e., P-APS) related to paclitaxel alone or combination of carboplatin. Methods: The Study was a prospective one in which we included the eligible patients scheduled to receive paclitaxel weekly or 3 weekly; alone or in combination with another chemotherapeutic agent Carboplatin. Details regarding acute Pain were collected and evaluated. Results: Majority of patient who developed P-APS, received combination of chemotherapy as compared to patients who received paclitaxel alone. Majority of patients (59.2%) developed onset of PAPS on day 2nd either received paclitaxel alone or combination of chemotherapy, however majority of patients received combination of chemotherapy remained symptomatic for more than 4days.The P-APS was measurement on the basis of scoring provided by LANSS pain scale, majority of patients had pain score of less than 12. As far as nature of pain was concerned, we found that the commonest complaints were pinpricking (37%) and dull (18.6%) rather than burning (14%), numbness (7%). Majority of patient experienced pain in the knees (37%) followed by in lower limbs (22.2%), hand (20%), feet (11%), and 5% in ankle. Conclusion: The incidence and characteristics of pain is related to paclitaxel dose. Subsequent cycles of paclitaxel are having no effect on intensity of pain syndrome. Duration of pain increased by combination of Paclitaxel and carboplatin. Addition of carboplatin contributed chronicity of pain.