Therapy with paclitaxel (Taxol) may be associated with development of arthralgias and myalgias, which can be severe enough to impact the patient's quality of life.
Patient selection: therapy with paclitaxel
Clinical features:
(1) The patient develops arthralgias and myalgias following paclitaxel therapy.
(2) The symptoms tend to occur after higher doses.
(3) The symptoms can result in significant impairment and/or impact on the patient's quality of life (QOL).
(4) Other causes of joint and muscle pain should be excluded. The pattern of occurrence relative to the chemotherapy schedule can aid in diagnosis.
A number of concurrent therapies may reduce the severity of the symptoms and can be given prophylactically. These may include low dose prednisone and/or NSAIDs. Others medications include gapapentin, antihistamines and glutamine. Severe pain may require use of opioid analgesics.
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