2015 Volume 125 Issue 5 Pages 1009-1015
Background: Most of the cutaneous melanoma patients with stage 2 or 3 disease in Japan have offered to undergo adjuvant therapy with intradermal injection of interferon beta (IFNβ). Nearly half of the patients in Japan develop melanoma in the hand or foot, severe pain due to the intradermal injection has been a problem. Materials and methods: To investigate the possibility of pain improvement by using a thinner 34 G needle when injecting IFNβ intradermally, we conducted a clinical trial by scoring pain using visual analog scale (VAS). While using 29-gauge (G) needle for a control group and 34 G needle for a trial group, this study was conducted as a single-group, single-blind test. Each enrolled patient were assigned the fixed schedule of using either 29 G or 34 G and was injected IFNβ for 10 treatment days. The mean VAS score for each needle gauge was calculated in each patient to calculate the difference in VAS (δVAS) and this difference was analyzed statistically. Results: A total of 38 patients were enrolled in this study with a total injection number of 308 times and 8.1 injections per each patient. The mean VAS scores for 29 G and 34 G were 55.9 mm and 43.5 mm, respectively (P<0.00001, Wilcoxon test). The mean δVAS was -12.4 mm which means a 22% reduction in VAS. Conclusion: Although the reduction of VAS partly depended on the injection schedule and the site, injection of IFNβ using a 34 G needle was shown to reduce the VAS scale in most of the patients. Reduction of pain due to the IFNβ resulting from using thinner needle may lead to the higher compliance in adjuvant therapy.
