G-CSF-Related Bone Pain and Supportive Care Strategies in Patients With Solid Tumors

This prospective two-center observational cohort study evaluated G-CSF-related bone pain and multidimensional symptom burden in adults with solid tumors receiving chemotherapy and filgrastim prophylaxis. Participants received one of two physician-selected supportive-care strategies as part of routine clinical practice: naproxen alone or naproxen plus loratadine. Pain was assessed using an 11-point Numeric Rating Scale (NRS) at baseline and on study day 8, with study day 1 defined as the first day of filgrastim administration. Patient-reported outcomes included the EORTC QLQ-C30, GAD-7, Beck Depression Inventory, and Pittsburgh Sleep Quality Index. A total of 190 patients were enrolled at Ankara Etlik City Hospital and Gazi University Faculty of Medicine.

Inclusion Criteria: * Age 18 years or older * Histologically or cytologically confirmed solid tumor * Receiving systemic chemotherapy with primary or secondary filgrastim prophylaxis * Eastern Cooperative Oncology Group performance status 0-3 * Written informed consent provided Exclusion Criteria: * Known bone metastases * Active opioid use at enrollment * Use of a nonsteroidal anti-inflammatory drug, opioid, or antihistamine within 2 days before enrollment, except for single doses administered before blood transfusion * Cognitive or communication impairment preventing completion of study questionnaires