Amiri Aref H, Jaferian Soleiman
Department of Rheumatology, Imam Khomeini hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Internal Medicine, Shohada Hospital, Lorestan University of Medical Sciences, Koramabad, Iran.
South Asian J Cancer. 2012 Oct;1(2):72-5. doi: 10.4103/2278-330X.103715.
Evaluate the characteristics of arthritis, arthralgia and musculoskeletal pain after chemotherapy in patients with lung cancer.
In this study, we evaluate the characteristics of 17 patients with joint symptoms following receiving chemotherapy for lung cancer. Demographic information of patients including sex, age, time of rheumatologic findings after starting of chemotherapy, time of improvement after starting of medication, and relevant laboratory findings for each patient.
A total of seventeen patients (six women with mean age 41.2 ± 5.2 years and 11 men with mean age 42.5 ± 8.2) that received standard chemotherapy for lung cancer according to stage of disease. Joint symptoms usually began about seven months after the first session of chemotherapy. Patients had an average of two tender joints and 1 hr of morning stiffness. Four patients were positive for anti-nuclear antibody, and none of patient was positive for rheumatoid factor. Non-steroidal anti-inflammatory drugs, disease modifying anti-rheumatic drugs (DMARD), corticosteroids, and venlafaxine were prescribed. Four patients did not show an improvement. Follow-up was available for all patients. 11 patients showed favorable responses, characterized by a significant decrease (more than 50%) in morning stiffness, pain, and tender joint counts after a mean of three months' treatment. Two patients had complete resolution of symptoms and did not required further medications for arthritis, arthralgia or musculoskeletal pain.
Chemotherapy-related arthropathy in lung cancer is not uncommon. Early treatment with NSAID, DMARD, and corticosteroids is effective in the majority of patients.
评估肺癌患者化疗后关节炎、关节痛和肌肉骨骼疼痛的特征。
在本研究中,我们评估了17例肺癌化疗后出现关节症状患者的特征。患者的人口统计学信息包括性别、年龄、化疗开始后出现风湿学表现的时间、用药开始后症状改善的时间以及每位患者的相关实验室检查结果。
共有17例患者(6名女性,平均年龄41.2±5.2岁;11名男性,平均年龄42.5±8.2岁)根据疾病分期接受了肺癌标准化疗。关节症状通常在首次化疗后约7个月开始出现。患者平均有两个压痛关节,晨僵时间为1小时。4例患者抗核抗体阳性,类风湿因子均为阴性。给予了非甾体抗炎药、改善病情抗风湿药(DMARD)、皮质类固醇和文拉法辛。4例患者症状未改善。所有患者均进行了随访。11例患者治疗效果良好,其特征为平均治疗3个月后晨僵、疼痛和压痛关节计数显著下降(超过50%)。2例患者症状完全缓解,无需进一步治疗关节炎、关节痛或肌肉骨骼疼痛。
肺癌化疗相关关节病并不少见。早期使用非甾体抗炎药、改善病情抗风湿药和皮质类固醇治疗对大多数患者有效。