Spectrum of musculoskeletal manifestations in patients undergoing drug therapy for malignant solid neoplasm

Abstract

The aim of the study was to describe the clinical types of musculoskeletal disorders (MDs) in patients undergoing anticancer drug therapy.

Patients and methods. 140 cancer patients (mean age 55.4 ± 13.0 years), receiving anticancer drug therapy, was examined by rheumatologist. The identified MDs was classified and described depending on its etiology.

Results. Various musculoskeletal manifestations were found in 113 (81%; 95% CI: 73-86%) patients, they included arthralgia in 83 (59.3%) patients, myalgia in 14 (10%), ostalgia in 14 (10%), joint stiffness ³30 min in the morning in 7 (5%), swelling in the joints in 19 (13.6%), back pain in 38 (27%). In 55 (39.3%; 95% CI 32-48%) of the examined patients MDs was associated with ongoing anticancer drug therapy, which manifested with acute taxane-induced pain syndrome in 24 patients, with post-chemotherapy arthritis/arthralgia in 13, musculoskeletal immune-related events of checkpoint inhibitors in 6, arthropathy associated with sex hormone suppression in 6, and with concomitant treatment in other cases. In 24 (17.1%; 95% CI 12–24%) examined patients, MDs was due to neoplastic (n=21) or paraneoplastic processes (n=3). Fifty-seven (40.7%; 95% CI 33–49%) patients had MDs unrelated to ongoing anticancer therapy, neoplasia, or paraneoplasia.

Conclusion. MDs in cancer patients performed by heterogenic manifestations is an understudied problem. The high prevalence of MDs in these patients explains that further researches are needed to study the clinical forms MDs and their impact on the outcomes of anticancer therapy and the quality of life of patients. The development of treatment guidelines of these conditions is also necessary. All this is possible only with collaboration between rheumatologists and oncologists.