• J Palliat Med · Nov 2017

    Case Reports

    Very-Low-Dose Methadone To Treat Refractory Neuropathic Pain in Children with Cancer.

    • Kevin Madden and Eduardo Bruera.
    • M.D. Anderson Cancer Center, University of Texas , Houston, Texas.
    • J Palliat Med. 2017 Nov 1; 20 (11): 1280-1283.

    BackgroundCompared with nociceptive pain, neuropathic pain is a challenging diagnosis to make and successfully treat in children with cancer.ObjectiveThe objective of this case report was to see whether very-low-dose methadone (VLDM) (defined as <50% of accepted starting analgesic dose of methadone for children) would be an effective strategy to treat refractory neuropathic pain due to vincristine in two children with acute lymphoblastic leukemia.MethodsThis case report is based on the clinical experience and parent-reported outcomes of two children with refractory neuropathic pain who received VLDM.ResultsBased on parent/caregiver-reported outcome scores over a one-year period, both children's refractory neuropathic pain syndrome was successfully treated with the addition of VLDM to their pre-existing regimen of gabapentin. Neither child suffered any adverse effects from methadone.ConclusionsVLDM shows promise as an effective, safe, and inexpensive way to treat refractory neuropathic pain in children with cancer.

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