Risk factors for vasculitis and vascular pain associated with cisplatin and vinorelbine in adjuvant chemotherapy.

[INTRODUCTION] Vinorelbine (VNR) frequently causes vasculitis and vascular pain during administration, potentially compromising treatment adherence and patient quality of life. This study aimed to identify risk factors and temporal distribution patterns for VNR associated with vasculitis and vascular pain, and to evaluate the prophylactic efficacy of NSAIDs and non-NSAID analgesics in patients receiving postoperative adjuvant chemotherapy.

[METHODS] We conducted a retrospective analysis of 49 non-small cell lung cancer patients who received cisplatin (CDDP) and VNR combination therapy. The treatment cycle was stratified into two temporal phases: "before day 8" (period between CDDP and VNR administration on day 1 and VNR monotherapy) and "after day 8" (period between VNR monotherapy and subsequent cycle initiation).

[RESULTS] Age under 65 years was significantly correlated with vasculitis and vascular pain occurrence ( = 0.003). The incidence rate was elevated during the "after day 8" period, with predominant manifestation during initial treatment cycles. Neither NSAIDs nor non-NSAID analgesics demonstrated significant prophylactic efficacy against these vascular adverse events.

[CONCLUSION] Our findings identify age under 65 years as an independent risk factor for VNR associated with vasculitis and vascular pain. The markedly higher incidence observed during the "after day 8" period suggests that intravascular VNR concentration may be a critical pathophysiological determinant.