Category: Professional Posters
Purpose: Vascular pain that accompanies the administration of dacarbazine is thought to be caused by photodegradation product of dacarbazine, 5-diazoimidazole-4-carboxamide (DIAZO-IC). However, the impact of DIAZO-IC level in the injection solution on the onset of vascular pain has not been clarified. In addition, although shading the injection solution for suppressing the production of DIAZO-IC is widely performed, the vascular pain is not sufficiently controlled. In this study, to clarify the cause of vascular pain, we investigated the impact of the DIAZO-IC concentration in the injection solution on the onset of vascular pain.
Methods: Ten skin cancer patients who received dacarbazine (total 95 administrations) were enrolled in this study. The relationship between patient backgrounds (concomitant drugs, medical history, body temperature and blood pressure at the time of administration), condition of dacarbazine administration (infusion rate, time required for preparation, time from preparation to administration completion) and the concentration of dacarbazine and DIAZO-IC concentration in the injection solution, and those impacts on the onset of vascular pain were assessed. Logistic regression analysis was performed to analyze factors affecting the onset of vascular pain, and factors affecting the concentration of DIAZO-IC in the drug were analyzed by multiple regression analysis. The concentration of DIAZO-IC in dacarbazine solution was measured by HPLC-UV method.
Results: In all cases, the injection solution was stored under shading conditions after preparation, and all bags and IV lines were shaded during administration. On the other hand, preparation was carried out without shading. The use of aprepitant (p<0.001) and infusion rate of DIAZO-IC (p = 0.043) were found to be significantly associated with the onset of vascular pain. No factor affecting the rate of production of DIAZO-IC was detected.
Conclusion: DIAZO-IC was detected in the infusion, despite storage in the light shielding condition. Since the infusion rate of DIAZO-IC affects the onset of vascular pain, preventing the production of DIAZO-IC is thought to be important to avoid vascular pain. Although no factor affecting the production of DIAZO-IC could be detected, we thought that the absence of light shielding at the time of preparation of the injection solution might be one of causes. To develop the method for avoiding vascular pain due to dacarbazine administration, more detail study to clarify the factors affecting the production of DIAZO-IC is needed.