Intrathecal Drug Delivery Systems for Refractory Pancreatic Cancer Pain: Observational Follow-up Study Over an 11-Year Period in a Comprehensive Cancer Center

Abstract

Despite our study's limitations, results suggest that long-term IDDS for refractory malignant pain due to pancreatic cancer was both efficacious and safe in pancreatic cancer pain. We have demonstrated, in the largest series of IDDS for pancreatic cancer pain reported yet, a clinically and statistically significant pain reduction in patients receiving IDDS.

Controversies on the endoscopic and surgical management of pain in patients with chronic pancreatitis: pros and cons!

“…More recently, neuromodulation has been developed as a less invasive treatment option, including spinal cord stimulation and targeted intrathecal pharmacotherapy (eg, morphine pump) 32. While these are considered relatively safe and produce significant pain reduction, there is a lack of randomised placebo-controlled trials to support it 33 34…”

Initiation of Intrathecal Drug Delivery Dramatically Reduces Systemic Opioid Use in Patients With Advanced Cancer

“…The primary outcome measure was a change in numerical rating scale (NRS) from pre‐implantation to post‐implantation. As part of IT dosing strategies, the authors do report a transition off of systemic opioid therapy but no specific measures are reported detailing the rate or degree of success (9).…”

“…Intrathecal drug delivery (IDD), also referred to as targeted drug delivery (TDD) or intrathecal therapy (ITT), has long been used for patients with inadequate pain control despite systemic opioid escalation or dose-limiting opioid-related side effects. IDD has been shown to improve analgesia, reduce medical costs, decrease hospital visits, reduce opioid-related side effects, decrease opioid consumption, effectively manage breakthrough pain, reduce serum opioid levels, and preserve quality of life in patients with severe cancer-related pain (6)(7)(8)(9)(10)(11)(12)(13). IDDS implantation carries risks, including infection, bleeding, neurologic injury, cerebrospinal fluid leak, and postdural puncture headache.…”

A Rare Complication of Ileus Following Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis: A Case Report

“…For these reasons, safe and effective alternative therapies are in high demand. These alternative therapies include CPN, celiac plexus block (CPB), splanchnicectomy, and intrathecal therapy [8][9][10].…”