Spinal cord stimulation for cancer-related pain in adults

Peng, Lihua; Min, Su; Zhou, Zejun; Wei, Ke; Bennett, Mike

doi:10.1002/14651858.cd009389.pub3

Cited by 46 publications

(26 citation statements)

References 43 publications

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“…171 A recent (2015) Cochrane review of spinal cord stimulation for cancer-related pain in adults concluded that the existing evidence base was insufficient to establish the role of SCS in cancer-related pain and more studies are needed. 172 For cancer survivors treated with opioids experiencing sideeffects or treatment refractory pain, an intrathecal drug delivery system (IDDS) may be considered. 173 By targeting the spinal cord, many systemic opioid-related side-effects can be avoided.…”

Section: Implantable Devices: Spinal Cord Stimulators and Intrathecalmentioning

confidence: 99%

Pain in cancer survivors; filling in the gaps

Brown

Farquhar-Smith

2017

British Journal of Anaesthesia

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Cancer survivorship represents a growing clinical challenge for pain clinicians. The population of cancer survivors is rapidly expanding and many of these patients experience pain as a sequelae of their disease and its treatment. The features, pathophysiology and natural history of some painful conditions observed in cancer survivors, such as direct tumour effects, cancer induced bone pain (CIBP) or chronic post-surgical pain have received extensive exposure elsewhere in the literature. In this narrative review, we attempt to 'fill in the gaps' in the knowledge, by providing a succinct outline of a range of less well known pain states encountered in the cancer survivor population. These include neuropathies as a result of graft versus host disease (GVHD), novel chemotherapeutic agents and monoclonal antibodies (mAb), and radiation induced pain states. The increasing prevalence of visceral post-surgical pain and aromatase inhibitor-induced arthralgia (AIA) is also detailed. Additionally an overview of suggested approaches to the assessment of pain in cancer survivors is provided and potential treatment strategies, with a focus on novel approaches are discussed.

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Section: Implantable Devices: Spinal Cord Stimulators and Intrathecalmentioning

confidence: 99%

Pain in cancer survivors; filling in the gaps

Brown

Farquhar-Smith

2017

British Journal of Anaesthesia

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“… 32 Spinal cord stimulation may be another option for these patients, but evidence regarding efficacy is lacking. 35 , 36 One of the valuable options for the palliative treatment of cancer pain in general, pancreatic cancer pain in particular, is the intrathecal or epidural port catheter use for opioid or local anesthetic administration, which represents an effective method for the end-of-life care of these patients. 37 – 39 Although many studies have reported successful results with mechanical splanchnicectomy, 40 , 41 this procedure may also lead to serious complications such as pneumothorax, chylothorax, spleen injury, and inter-costal neuralgia.…”

Section: Discussionmentioning

confidence: 99%

<p>Pain Control with Splanchnic Neurolysis in Pancreatic Cancer Patients Unresponsive to Celiac Plexus Neurolysis</p>

Comlek¹

2020

JPR

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Background/Aims In most instances of abdominal pain associated with pancreatic cancer, pain may become refractory to increasing doses of narcotics. Celiac plexus neurolysis represents an option; however, altered celiac plexus anatomy may render this treatment infeasible or ineffective, where splanchnic nerve neurolysis may represent another option. This study aimed to investigate the outcomes of splanchnic neurolysis in pancreatic cancer patients not responsive to celiac plexus neurolysis. Patients and Methods Among all 84 patients who underwent celiac plexus neurolysis for pancreatic cancer pain during the study period, 34 patients did not respond and underwent splanchnic nerve neurolysis under fluoroscopic guidance and thus included in this retrospective study. Stage IV, III, and II disease was present in 38.2%, 47.1%, and 14.7% of the patients. During the study, 88.2% were receiving chemotherapy, whereas none were on radiotherapy. Data for daily narcotic dose equivalents and Visual Analogue Scale (VAS) scores during outpatient visits at baseline, 2 weeks, 2 months, and 3 months were extracted. Results Pain response rates were 76.5%, 84.4%, and 71.0%, at 2 weeks, 2 months, and 3 months, respectively. A significant and dramatic reduction was seen in VAS scores at 2 weeks (2.8±1.2 versus 6.3±1.1, p<0.001), and this significant decline was maintained for 3 months. Similarly, a significant and dramatic reduction was seen in daily narcotic need at 2 weeks (20.8±32.9 versus 93.4±86.2 mg, p<0.001), which was also maintained during the 3-month follow-up. The procedure was generally well tolerated. Conclusion Findings of this study suggest that splanchnic neurolysis represents a durable and effective option for pain control in pancreatic cancer patients in whom the neurolysis of the celiac plexus is ineffective. However, these conclusions refer to only preliminary single-center results in a selected patient group; thus, further large studies are warranted.

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“… 92 These issues will be considered when conducting sensitivity analyses based on methodological quality and when interpreting results. 93 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of acupuncture for cancer pain: protocol for an umbrella review and meta-analyses of controlled trials

Liu

May

et al. 2017

BMJ Open

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Introduction The National Comprehensive Cancer Network guidelines for adult cancer pain indicate that acupuncture and related therapies may be valuable additions to pharmacological interventions for pain management. Of the systematic reviews related to this topic, some concluded that acupuncture was promising for alleviating cancer pain, while others argued that the evidence was insufficient to support its effectiveness.Methods and analysisThis review will consist of three components: (1) synthesis of findings from existing systematic reviews; (2) updated meta-analyses of randomised clinical trials and (3) analyses of results of other types of clinical studies. We will search six English and four Chinese biomedical databases, dissertations and grey literature to identify systematic reviews and primary clinical studies. Two reviewers will screen results of the literature searches independently to identify included reviews and studies. Data from included articles will be abstracted for assessment, analysis and summary. Two assessors will appraise the quality of systematic reviews using Assessment of Multiple Systematic Reviews; assess the randomised controlled trials using the Cochrane Collaboration’s risk of bias tool and other types of studies according to the Newcastle-Ottawa Scale. We will use ‘summary of evidence’ tables to present evidence from existing systematic reviews and meta-analyses. Using the primary clinical studies, we will conduct meta-analysis for each outcome, by grouping studies based on the type of acupuncture, the comparator and the specific type of pain. Sensitivity analyses are planned according to clinical factors, acupuncture method, methodological characteristics and presence of statistical heterogeneity as applicable. For the non-randomised studies, we will tabulate the characteristics, outcome measures and the reported results of each study. Consistencies and inconsistencies in evidence will be investigated and discussed. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of the overall evidence.Ethics and disseminationThere are no ethical considerations associated with this review. The findings will be disseminated in peer-reviewed journals or conference presentations.PROSPERO registration numberCRD42017064113.

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Spinal cord stimulation for cancer-related pain in adults

Cited by 46 publications

References 43 publications

Pain in cancer survivors; filling in the gaps

Pain in cancer survivors; filling in the gaps

<p>Pain Control with Splanchnic Neurolysis in Pancreatic Cancer Patients Unresponsive to Celiac Plexus Neurolysis</p>

Effectiveness of acupuncture for cancer pain: protocol for an umbrella review and meta-analyses of controlled trials

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