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Supportive Care in Cancer
Erschienen in: Supportive Care in Cancer 3/2016

01.03.2016 | Review Article

Interventional options for the management of refractory cancer pain—what is the evidence?

verfasst von: Petra Vayne-Bossert, Banafsheh Afsharimani, Phillip Good, Paul Gray, Janet Hardy

Erschienen in: Supportive Care in Cancer | Ausgabe 3/2016

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Abstract

Purpose

Pain is the most common symptom in cancer patients. Standard pain treatment according to the WHO three-step analgesic ladder provides effective pain management in approximately 70–90 % of cancer patients. Refractory pain is defined as not responding to “standard” treatments. Interventional analgesic techniques can be used in an attempt to control refractory pain in patients in whom conventional analgesic strategies fail to provide effective pain relief or are intolerable due to severe adverse effects. This systematic review aims to provide the latest evidence on interventional refractory pain management in cancer patients.

Methods

Systematic literature search in Cochrane, EMBASE and PubMed including reviews and randomised controlled trials (RCTs) and non-randomised controlled trials in the absence of reviews.

Results

Neuraxial analgesia may play a role in refractory cancer pain management. Paravertebral blocks decrease the incidence of persistent post-surgical pain after breast cancer. Coeliac plexus blocks improve pain scores in refractory pancreatic cancer pain for up to 4 weeks after the intervention with fewer burdensome side effects as compared to opioids. Cordotomy has mainly been studied in mesothelioma, and the case series suggest possible benefit for pain at the expense of a relatively high risk of side effects.

Conclusions

Overall, very few RCTs have been conducted on interventional pain techniques. In reality, it is very difficult to undertake large controlled trials for a number of reasons. Therefore, today’s best evidence for practice may be from large case series of comparable patients with careful response and toxicity evaluation and follow-up.
Literatur
1.
van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol Off J Eur Soc Med Oncol ESMO 18(9):1437–1449. doi:10.​1093/​annonc/​mdm056 CrossRef
2.
Organization WH (1996) Cancer pain relief and palliative care: a report of a WHO Expert Committee, 3rd edn. World Health Organization, Geneva
3.
Zech DF, Grond S, Lynch J, Hertel D, Lehmann KA (1995) Validation of World Health Organization guidelines for cancer pain relief: a 10-year prospective study. Pain 63(1):65–76CrossRefPubMed
4.
Vargas-Schaffer G (2010) Is the WHO analgesic ladder still valid? Twenty-four years of experience. Can Fam Physician 56(6):514–517, + e202-e205PubMedCentralPubMed
5.
Miguel R (2000) Interventional treatment of cancer pain: the fourth step in the world health organization analgesic ladder? Cancer Control 7(2):149–156PubMed
6.
7.
Afsharimani B, Kindl K, Good P, Hardy J (2015) Pharmacological options for the management of refractory cancer pain-what is the evidence? Support Care Cancer Off J Multinatl Assoc Support Care Cancer 23(5):1473–1481. doi:10.​1007/​s00520-015-2678-9
8.
Kassamali RH, Ganeshan A, Hoey ET, Crowe PM, Douis H, Henderson J (2011) Pain management in spinal metastases: the role of percutaneous vertebral augmentation. Ann Oncol Off J Eur Soc Med Oncol ESMO 22(4):782–786. doi:10.​1093/​annonc/​mdq605 CrossRef
9.
Buchbinder R, Golmohammadi K, Johnston RV, Owen RJ, Homik J, Jones A, Dhillon SS, Kallmes DF, Lambert RG (2015) Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database Syst Rev 4:CD006349. doi:10.​1002/​14651858.​CD006349.​pub2 PubMed
10.
Ploeg WT, Veldhuizen AG, The B, Sietsma MS (2006) Percutaneous vertebroplasty as a treatment for osteoporotic vertebral compression fractures: a systematic review. Eur Spine J 15(12):1749–1758CrossRefPubMed
11.
Bhargava A, Trivedi D, Kalva L, Tumas M, Hooks M, Speth J (2009) Management of cancer-related vertebral compression fracture: comparison of treatment options: a literature meta-analysis. J Clin Oncol 27(15):e20529
12.
Chew C, Craig L, Edwards R, Moss J, O’Dwyer PJ (2011) Safety and efficacy of percutaneous vertebroplasty in malignancy: a systematic review (Provisional abstract). Clin Radiol 66(1):63–72CrossRefPubMed
13.
Schroeder JE, Ecker E, Skelly AC, Kaplan L (2011) Cement augmentation in spinal tumors: a systematic review comparing vertebroplasty and kyphoplasty (provisional abstract). Evid Based Spine-Care J 2(4):35–43PubMedCentralCrossRefPubMed
14.
Khan YN, Raza SS, Khan EA (2006) Spinal cord stimulation in visceral pathologies. Pain Med 7(SUPPL 1):S121–S125CrossRef
15.
Bouza C, Lapez-Cuadrado T, Cediel P, Saz-Parkinson Z, Amate JM (2009) Balloon kyphoplasty in malignant spinal fractures: a systematic review and meta-analysis. BMC Palliat Care 8
16.
17.
McGirt MJ, Parker SL, Wolinsky JP, Witham TF, Bydon A, Gokaslan ZL (2009) Vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: an evidenced-based review of the literature. Spine J Off J N Am Spine Soc 9(6):501–508. doi:10.​1016/​j.​spinee.​2009.​01.​003 CrossRef
18.
Taylor RS, Fritzell P, Taylor RJ (2007) Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis (provisional abstract). Eur Spine J 16(8):1085–1100PubMedCentralCrossRefPubMed
19.
Mercadante S (1998) Controversies over spinal treatment in advanced cancer patients. Support Care Cancer 6(6):495–502CrossRefPubMed
20.
Jones RL, Rawlins PK (2005) The diagnosis of intrathecal infusion pump system failure. Pain Physician 8(3):291–296PubMed
21.
Devulder J, Ghys L, Dhondt W, Rolly G (1994) Spinal analgesia in terminal care: risk versus benefit. J Pain Symptom Manag 9(2):75–81CrossRef
22.
Holmfred A, Vikerfors T, Berggren L, Gupta A (2006) Intrathecal catheters with subcutaneous port systems in patients with severe cancer-related pain managed out of hospital: the risk of infection. J Pain Symptom Manag 31(6):568–572CrossRef
23.
Malheiro L, Gomes A, Barbosa P, Santos L, Sarmento A (2015) Infectious complications of intrathecal drug administration systems for spasticity and chronic pain: 145 patients from a tertiary care center. Neuromodulation J Int Neuromodulation Soc 18(5):421–426CrossRef
24.
Deer TR, Caraway DL, Kim CK, Dempsey CD, Stewart CD, McNeil KF (2002) Clinical experience with intrathecal bupivacaine in combination with opioid for the treatment of chronic pain related to failed back surgery syndrome and metastatic cancer pain of the spine. Spine J Off J N Am Spine Soc 2(4):274–278CrossRef
25.
26.
Hitt JM, de Leon-Casasola OA (2011) Complications of intrathecal drug delivery systems. Tech Reg Anesth Pain Manag 15:162–166CrossRef
27.
Dahm P, Nitescu P, Appelgren L, Curelaru I (1998) Efficacy and technical complications of long-term continuous intraspinal infusions of opioid and/or bupivacaine in refractory nonmalignant pain: a comparison between the epidural and the intrathecal approach with externalized or implanted catheters and infusion pumps. Clin J Pain 14(1):4–16CrossRefPubMed
28.
Deer TR, Prager J, Levy R, Rathmell J, Buchser E, Burton A, Caraway D, Cousins M, De Andres J, Diwan S, Erdek M, Grigsby E, Huntoon M, Jacobs MS, Kim P, Kumar K, Leong M, Liem L, McDowell GC 2nd, Panchal S, Rauck R, Saulino M, Sitzman BT, Staats P, Stanton-Hicks M, Stearns L, Wallace M, Willis KD, Witt W, Yaksh T, Mekhail N (2012) Polyanalgesic Consensus Conference 2012: recommendations for the management of pain by intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel. Neuromodulation J Int Neuromodulation Soc 15(5):436–464. doi:10.​1111/​j.​1525-1403.​2012.​00476.​x, discussion 464–436CrossRef
29.
Prager J, Deer T, Levy R, Bruel B, Buchser E, Caraway D, Cousins M, Jacobs M, McGlothlen G, Rauck R, Staats P, Stearns L (2014) Best practices for intrathecal drug delivery for pain. Neuromodulation J Int Neuromodulation Soc 17(4):354–372CrossRef
30.
Dupoiron D, Bore F, Lefebvre-Kuntz D, Brenet O, Debourmont S, Dixmerias F, Buisset N, Lebrec N, Monnin D (2012) Ziconotide adverse events in patients with cancer pain: a multicenter observational study of a slow titration, multidrug protocol. Pain Physician 15(5):395–403PubMed
31.
32.
Deer TR, Prager J, Levy R, Rathmell J, Buchser E, Burton A, Caraway D, Cousins M, De Andrés J, Diwan S, Erdek M, Grigsby E, Huntoon M, Jacobs MS, Kim P, Kumar K, Leong M, Liem L, Ii GCM, Panchal S, Rauck R, Saulino M, Todd Sitzman B, Staats P, Stanton-Hicks M, Stearns L, Wallace M, Dean Willis K, Witt W, Yaksh T, Mekhail N (2012) Polyanalgesic consensus conference 2012: recommendations for the management of pain by intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel. Neuromodulation 15(5):436–464CrossRefPubMed
33.
Ripamonti CI, Santini D, Maranzano E, Berti M, Roila F, Group EGW (2012) Management of cancer pain: ESMO clinical practice guidelines. Ann Oncol Off J Eur Soc Med Oncol ESMO 23(Suppl 7):vii139–vii154. doi:10.​1093/​annonc/​mds233 CrossRef
34.
Myers J, Chan V, Jarvis V, Walker-Dilks C (2010) Intraspinal techniques for pain management in cancer patients: a systematic review. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 18(2):137–149. doi:10.​1007/​s00520-009-0784-2
35.
Manchikanti L, Falco FJ, Singh V, Benyamin RM, Racz GB, Helm S 2nd, Caraway DL, Calodney AK, Snook LT, Smith HS, Gupta S, Ward SP, Grider JS, Hirsch JA (2013) An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part I: introduction and general considerations. Pain Physician 16(2 Suppl):S1–S48PubMed
36.
Kurita GP, Kaasa S, Sjogren P (2011) Spinal opioids in adult patients with cancer pain: a systematic review: a European Palliative Care Research Collaborative (EPCRC) opioid guidelines project. Palliat Med 25(5):560–577. doi:10.​1177/​0269216310386279​ CrossRefPubMed
37.
Bruera E, Hui D (2010) Spinal analgesia: where is the evidence? Support Care Cancer Off J Multinatl Assoc Support Care Cancer 18(10):1237. doi:10.​1007/​s00520-010-0881-2, author reply 1239–1240
38.
Raffaeli W, Andruccioli J, Righetti D, Caminiti A, Balestri M (2006) Intraspinal therapy for the treatment of chronic pain: a review of the literature between 1990 and 2005 and suggested protocol for its rational and safe use. Neuromodulation J Int Neuromodulation Soc 9(4):290–308. doi:10.​1111/​j.​1525-1403.​2006.​00071.​x CrossRef
39.
40.
Burton AW, Rajagopal A, Shah HN, Mendoza T, Cleeland C, Hassenbusch ISJ, Arens JF (2004) Epidural and intrathecal analgesia is effective in treating refractory cancer pain. Pain Med 5(3):239–247CrossRefPubMed
41.
Smith TJ, Coyne PJ (2005) Implantable drug delivery systems (IDDS) after failure of comprehensive medical management (CMM) can palliate symptoms in the most refractory cancer pain patients. J Palliat Med 8(4):736–742CrossRefPubMed
42.
Smith TJ, Staats PS, Deer T, Stearns LJ, Rauck RL, Boortz-Marx RL, Buchser E, Catala E, Bryce DA, Coyne PJ, Pool GE (2002) Randomized clinical trial of an implantable drug delivery system compared with comprehensive medical management for refractory cancer pain: impact on pain, drug-related toxicity, and survival. J Clin Oncol 20(19):4040–4049CrossRefPubMed
43.
Rauck RL, Cherry D, Boyer MF, Kosek P, Dunn J, Alo K (2003) Long-term intrathecal opioid therapy with a patient-activated, implanted delivery system for the treatment of refractory cancer pain. J Pain Off J Am Pain Soc 4(8):441–447CrossRef
44.
Hayek SM, Deer TR, Pope JE, Panchal SJ, Patel VB (2011) Intrathecal therapy for cancer and non-cancer pain. Pain Physician 14(3):219–248PubMed
45.
Ver Donck A, Vranken JH, Puylaert M, Hayek S, Mekhail N, Van Zundert J (2014) Intrathecal drug administration in chronic pain syndromes. Pain Pract 14(5):461–476PubMed
46.
Staats PS, Yearwood T, Charapata SG, Presley RW, Wallace MS, Byas-Smith M, Fisher R, Bryce DA, Mangieri EA, Luther RR, Mayo M, McGuire D, Ellis D (2004) Intrathecal ziconotide in the treatment of refractory pain in patients with cancer or AIDS: a randomized controlled trial. JAMA 291(1):63–70. doi:10.​1001/​jama.​291.​1.​63 CrossRefPubMed
47.
Rauck RL, Wallace MS, Leong MS, Minehart M, Webster LR, Charapata SG, Abraham JE, Buffington DE, Ellis D, Kartzinel R, Ziconotide 301 Study G (2006) A randomized, double-blind, placebo-controlled study of intrathecal ziconotide in adults with severe chronic pain. J Pain Symptom Manag 31(5):393–406. doi:10.​1016/​j.​jpainsymman.​2005.​10.​003 CrossRef
48.
Wallace MS, Kosek PS, Staats P, Fisher R, Schultz DM, Leong M (2008) Phase II, open-label, multicenter study of combined intrathecal morphine and ziconotide: addition of ziconotide in patients receiving intrathecal morphine for severe chronic pain. Pain Med 9(3):271–281. doi:10.​1111/​j.​1526-4637.​2007.​00355.​x CrossRefPubMed
49.
50.
Goudas LC, Carr DB, Filos KS (1998) The spinal clonidine opioid analgesic interaction: from laboratorz animals to the postoperative ward—a literature review of preclinical and clinical evidence. Analgesia 3:277–290
51.
Yaksh TL, Malmberg AB (1994) Interaction of spinal modulatory receptor systems. In: Fields HL, Liebeskinid JC (eds) Pharmacological approaches to the treatment of chronic pain. IASP Press, Seattle, pp 151–171
52.
Eisenach JC, DuPen S, Dubois M, Miguel R, Allin D (1995) Epidural clonidine analgesia for intractable cancer pain. Pain 61(3):391–399CrossRefPubMed
53.
Rockemann MG, Seeling W, Brinkmann A, Goertz AW, Hauber N, Junge J, Georgieff M (1995) Analgesic and hemodynamic effects of epidural clonidine, clonidine/morphine, and morphine after pancreatic surgery—a double-blind study. Anesth Analg 80(5):869–874PubMed
54.
Sjoberg M, Appelgren L, Einarsson S, Hultman E, Linder LE, Nitescu P, Curelaru I (1991) Long-term intrathecal morphine and bupivacaine in ‘refractory’ cancer pain. I. Results from the first series of 52 patients. Acta Anaesthesiol Scand 35(1):30–43CrossRefPubMed
55.
Sjoberg M, Nitescu P, Appelgren L, Curelaru I (1994) Long-term intrathecal morphine and bupivacaine in patients with refractory cancer pain: results from a morphine: bupivacaine dose regimen of 0.5:4.75 mg/ml. Anesthesiology 80(2):284–297CrossRefPubMed
56.
Van Dongen RTM, Crul BJP, Van Egmond J (1999) Intrathecal coadministration of bupivacaine diminishes morphine dose progression during long-term intrathecal infusion in cancer patients. Clin J Pain 15(3):166–172CrossRefPubMed
57.
Lauretti GR, Gomes JMA, Reis MP, Pereira NL (1999) Low doses of epidural ketamine or neostigmine, but not midazolam, improve morphine analgesia in epidural terminal cancer pain therapy. J Clin Anesth 11(8):663–668CrossRefPubMed
58.
Yang CY, Wong CS, Chang JY, Ho ST (1996) Intrathecal ketamine reduces morphine requirements in patients with terminal cancer pain. Can J Anaesth 43(4):379–383CrossRefPubMed
59.
Ballantyne JC, Carwood C, Gupta A, Bennett MI, Simpson KH, Dhandapani K, Lynch L, Baranidharan G (2013) WITHDRAWN: comparative efficacy of epidural, subarachnoid, and intracerebroventricular opioids in patients with pain due to cancer. Cochrane Database Syst Rev 10:D005178
60.
61.
Andreae MH, Andreae DA (2012) Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery. Cochrane Database Syst Rev (Online) 10:CD007105
62.
Richman JM, Liu SS, Courpas G, Wong R, Rowlingson AJ, McGready J, Cohen SR, Wu CL (2006) Does continuous peripheral nerve block provide superior pain control to opioids? A meta-analysis. Anesth Analg 102(1):248–257CrossRefPubMed
63.
Fischer HBJ, Peters TM, Fleming IM, Else TA (1996) Peripheral nerve catheterization in the management of terminal cancer pain. Reg Anesth 21(5):482–485PubMed
64.
Casati A, Vinciguerra F, Scarioni M, Cappelleri G, Aldegheri G, Manzoni P, Fraschini G, Chelly JE (2003) Lidocaine versus ropivacaine for continuous interscalene brachial plexus block after open shoulder surgery. Acta Anaesthesiol Scand 47(3):355–360CrossRefPubMed
65.
Picard PR, Tramer MR, McQuay HJ, Andrew Moore R (1997) Analgesic efficacy of peripheral opioids (all except intra-articular): a qualitative systematic review of randomised controlled trials. Pain 72(3):309–318CrossRefPubMed
66.
67.
68.
Raslan AM, Cetas JS, McCartney S, Burchiel KJ (2011) Destructive procedures for control of cancer pain: the case for cordotomy: a review. J Neurosurg 114(1):155–170CrossRefPubMed
69.
70.
Grahm AL, Andren-Sandberg A (1997) Prospective evaluation of pain in exocrine pancreatic cancer. Digestion 58(6):542–549CrossRefPubMed
71.
Bapat AA, Hostetter G, Von Hoff DD, Han H (2011) Perineural invasion and associated pain in pancreatic cancer. Nat Rev Cancer 11(10):695–707CrossRefPubMed
72.
Bradley IEL, Bem J (2003) Nerve blocks and neuroablative surgery for chronic pancreatitis. World J Surg 27(11):1241–1248CrossRefPubMed
73.
McCartney CJL, Chambers WA (1998) Coeliac plexus block. Curr Anaesth Crit Care 9(6):318–324CrossRef
74.
Fugere F, Lewis G (1993) Coeliac plexus block for chronic pain syndromes. Can J Anaesth 40(10):954–963CrossRefPubMed
75.
Zhong W, Yu Z, Zeng JX, Lin Y, Yu T, Min XH, Yuan YH, Chen QK (2014) Celiac plexus block for treatment of pain associated with pancreatic cancer: a meta-analysis. Pain Pract 14(1):43–51. doi:10.​1111/​papr.​12083 CrossRefPubMed
76.
77.
Arcidiacono PG, Calori G, Carrara S, McNicol ED, Testoni PA (2011) Celiac plexus block for pancreatic cancer pain in adults. Cochrane Database Syst Rev (Online) 3:CD007519
78.
Puli SR, Reddy JBK, Bechtold ML, Antillon MR, Brugge WR (2009) EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain: a meta-analysis and systematic review. Dig Dis Sci 54(11):2330–2337CrossRefPubMed
79.
Kaplan R, Schiff-Keren B, Alt E (1995) Aortic dissection as a complication of celiac plexus block. Anesthesiology 83(3):632–635CrossRefPubMed
80.
Davies DD (1993) Incidence of major complications of neurolytic coeliac plexus block. J R Soc Med 86(5):264–266PubMedCentralPubMed
81.
Huang L, Tao F, Wang Z, Wan H, Qu P, Zheng H (2014) Combined neurolytic block of celiac and superior hypogastric plexuses for incapacitating upper abdominal cancer pain. J BUON 19(3):826–830PubMed
82.
Tsigaridas N, Naka K, Tsapogas P, Pelechas E, Damigos D (2015) Spinal cord stimulation in refractory angina. A systematic review of randomized controlled trials. Acta Cardiol 70(2):233–243PubMed
83.
Ubbink DT, Vermeulen H (2013) Spinal cord stimulation for non-reconstructable chronic critical leg ischaemia. Cochrane Database Syst Rev (Online) 2:CD004001
84.
Klomp HM, Steyerberg EW, Habbema JDF, van Urk H (2009) What is the evidence on efficacy of spinal cord stimulation in (subgroups of) patients with critical limb ischemia? Ann Vasc Surg 23(3):355–363CrossRefPubMed
85.
Taylor RS, Buyten JPV, Buchser E (2006) Spinal cord stimulation for complex regional pain syndrome: a systematic review of the clinical and cost-effectiveness literature and assessment of prognostic factors. Eur J Pain 10(2):91–101CrossRefPubMed
86.
Simpson EL, Duenas A, Holmes MW, Papaioannou D, Chilcott J (2009) Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin: systematic review and economic evaluation. Health Technol Assess 13(17):iii–72CrossRef
87.
88.
Metadaten
Titel
Interventional options for the management of refractory cancer pain—what is the evidence?
verfasst von
Petra Vayne-Bossert
Banafsheh Afsharimani
Phillip Good
Paul Gray
Janet Hardy
Publikationsdatum
01.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 3/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-3047-4

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