Intraventricular Octreotide for Cancer Pain

Candrina, R; Galli, Giulia

doi:10.3171/jns.1992.76.2.0336a

Cited by 2 publications

(1 citation statement)

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“…Epidural somatostatin was successfully implemented in analgesia of upper abdominal surgery and cancer pain (Taurà et al 1994;Beltrutti et al 2000). Intratracheal octreotide infusion was sufficient in cancer paint intraventricular could be potentially useful in patients with head and neck cancer exhibiting local nonopioid-sensitive pain (Candrina and Galli 1992;Penn et al 1992). Intravenous infusion of octreotide was found to cause pain relief after major abdominal surgery and cluster headache (Sicuteri et al 1984a;Caleri et al 1987;Dahaba et al 2009).…”

Section: Discussionmentioning

confidence: 99%

A study of acromegaly-associated headache with somatostatin analgesia

Kaniuka-Jakubowska

Levy

Pal

et al. 2023

Endocrine-Related Cancer

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To characterise somatostatin analogue responsive headache in acromegaly, hitherto not systematically documented in a significant cohort. Using the UK pituitary network, we have clinically characterised a cohort of 18 patients suffering from acromegaly-related headache with a clear response to somatostatin analogues. The majority of patients had chronic migraine (78%) as defined by the International Headache Society diagnostic criteria. Headache was present at the time of acromegaly presentation and clearly associated temporally with disease activity in all cases. Short-acting somatostatin analogues uniquely resolved pain within minutes and the mean duration of analgesia was 1-6 hours. Patients on long-acting analogues required less short-acting injections (mean 3.7 vs. 10.4 injections per day, p=0.005). 94% used somatostatin analogues to control ongoing headache pain. All patients presented with macroadenoma, most had incomplete resection (94%) and headache was ipsilateral to remnant tissue (94%). Although biochemical control was achieved in 78% of patients, headache remained in 71% of them. Patients selected for this study had ongoing headache post-treatment (mean duration 16 years after diagnosis); only 4 patients reached headache remission 26 years (mean, range 14-33) after the diagnosis. Headache in acromegaly patients can be persistent, severe, unrelieved by surgery, long-lasting and uncoupled from biochemical control. We show here that long-acting analogues allow a decrease in the number of short-acting analogue injections for headache relief. Further studies are needed to understand the mechanisms, markers and tumour tissue characteristics of acromegaly-related headache. Until then, this publication serves to provide the clinical characteristics as a reference point for further study.

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