G-CSF-Induced Bone Pain and Supportive Care Approaches

Inclusion Criteria: * Age 18-70 years * Histologically or cytologically confirmed solid tumor * Receiving chemotherapy with prophylactic or secondary prophylactic G-CSF (filgrastim, pegfilgrastim, or lipegfilgrastim) * ECOG performance status 0-3 * Able to complete patient-reported outcome questionnaires (VAS, QLQ-C30, FACT-G, FACT-F, PHQ-9, GAD-7, BDI, PSQI) * Written informed consent provided Exclusion Criteria: * Known bone metastases (confounds bone pain assessment) * Use of NSAIDs, opioids, or antihistamines within 48 hours prior to G-CSF administration * Patients not indicated for G-CSF prophylaxis * Severe cognitive impairment or communication barrier preventing completion of questionnaires * Active concurrent malignancy requiring systemic therapy * Known hypersensitivity to G-CSF or supportive care medications * Investigator judgment that participation may compromise data integrity or patient safety * ECOG performance status 4