Endovascular Denervation May Offer New Approach to Cancer Pain Relief
Endovascular denervation (EDN) can improve pain in patients with abdominal cancer and may offer a new approach to palliative care, according to a study published in the Journal of Vascular and Interventional Radiology.
The study enrolled 7 patients with diagnoses including pancreatic cancer (n = 3), cervical carcinoma (n = 2), cholangiocarcinoma (n = 1), and esophageal cancer with retroperitoneum lymph nodes invasion (n = 1) from April 2017 to February 2018.
On the back of each patient a surface electrode was placed and connected to the denervation device. Denervation was carried out at the abdominal aorta close to the origin of celiac artery and superior mesenteric artery with the use of a multielectrode radiofrequency ablation catheter with settings of time 120 seconds and temperature 60°C.
The primary endpoint was improvement in pain. Secondary endpoints included changes in quality of life, intake of narcotics, and the safety of EDN.
The authors reported that all patients experience pain relief after treatment. At 1, 2, 4, 8, and 12 weeks after the procedure pain scores decreased significantly compared with baseline (P < 0.001). All patients experienced a >4 score reduction.
Narcotics use was significantly reduced within the first 3 months after treatment and quality of life scores were improved significantly (P < 0.005) with better sleep. There were no severe treatment-related adverse events reported.
“Cancer pain management is a formidable problem for physicians and may result in a substantial burden to the public health care system. Opioid analgesics are often required to control cancer pain. AEs from opioids are debilitating and worsen as larger doses are administered,” the authors wrote. “This preliminary trial demonstrated that EDN is a promising and safe method for the palliation of pain caused by abdominal cancers. It could be a new approach for management of cancer pain.”
Qi Zhang, MD, Jin-He Guo, MD, Hai-Dong Zhu, et al. Endovascular Denervation: A New Approach for Cancer Pain Relief? J Vasc Interv Radiol. 2018; S1051-0443(18)31415-5. doi: 10.1016/j.jvir.2018.08.008. [Epub ahead of print].