A Retrospective Investigation of the Relationship between Neuroblastoma
Response to Cancer Therapy and Exposure to Opioids for Pain Management
Abstract
ABSTRACT Objective: Recent increased awareness and research studies
reflect possible associations between opioid exposure and cancer
outcomes. Children with neuroblastoma (NB) often require opioid
treatment for pain. However, associations between tumor response to
chemotherapy and opioid exposure have not been investigated in clinical
settings. Methods: This is a single institution retrospective review of
patients with NB treated between 2013 and 2016. We evaluated opioid
consumption quantified in morphine equivalent doses (mg/kg) based on
nurse- or patient-controlled analgesia during antibody infusions. We
also analyzed their associations with change in tumor volume and
extra-adrenal tumor burden. Results: Of 42 patients given opioids for
pain related to anti-GD2 mAb, data completion was achieved for 36 and
details of statistical analyses were entered. Median total weight-based
morphine equivalent (over 8 days) was 4.71 mg/kg (interquartile range
3.49-7.96). We found a statistically insignificant weak negative
relationship between total weight-based morphine equivalents and tumor
volume ratio (correlation coefficient -0.0103, p-value 0.9525) and a
statistically insignificant weak positive relationship between total
weight-based morphine equivalent and Curie score (correlation
coefficient 0.1096, p-value 0.5247). Conclusion: Our study found no
statistically significant correlation between opioid consumption and NK
cell-mediated killing of NB cells as measured by effects on tumor
volume/tumor load.