Management of refractory cancer pain with intrathecal drug delivery and spinal cord stimulation Journal Article
| Authors: | Bulat, E.; Crowther, J. E.; Chakravarthy, V.; Laufer, I.; Barzilai, O.; Gulati, A. |
| Article Title: | Management of refractory cancer pain with intrathecal drug delivery and spinal cord stimulation |
| Abstract: | Background: Intrathecal pumps (ITPs) are indicated for refractory cancer pain and decrease systemic opioid requirements. While not yet indicated for cancer pain, spinal cord stimulators (SCSs) are used off-label for cancer pain, with increasing evidence of their efficacy. Materials and Methods: A retrospective chart review was conducted of patients who underwent both ITP and at least SCS trial for cancer pain. Primary outcomes were pain numeric rating scale (NRS) and daily morphine equivalents (MEQs). Results: Seventeen patients were identified. Both ITP and SCS were associated with significant decreases in pain ratings at the 3-month follow-up, but this decrease became nonsignificant subsequently. ITP, but not SCS, was associated with a significant decrease in MEQ. Conclusions: ITP and SCS may both provide efficacy for cancer pain, but the opioid-sparing effects of SCS may be limited. ITP and SCS may potentially be complementary in their ability to provide relief from cancer-related pain. © Evgeny Bulat et al., 2024; Published by Mary Ann Liebert, Inc. |
| Keywords: | adult; clinical article; primary tumor; cancer patient; pancreas cancer; outcome assessment; follow up; endometrium cancer; colorectal cancer; metastasis; breast cancer; opiate; cohort analysis; lung cancer; cancer pain; neuromodulation; medical record review; retrospective study; cancer therapy; abdominal pain; backache; prostate cancer; sarcoma; cancer center; thorax pain; outpatient department; limb pain; hospital patient; thyroid cancer; symptomatology; opioids; kidney cancer; testis cancer; analgesia; pain assessment; postoperative pain; neuropathic pain; demographics; patient-reported outcome; parotid gland cancer; refractory cancer; intrathecal pump; human; male; female; article; pelvic pain; nociceptive pain; numeric rating scale; device failure; postdural puncture headache; morphine equivalent dose; spinal cord stimulator; blood patch; catheter tip migration; device migration; nerve cancer; spinal cord stimulator lead migration |
| Journal Title: | Palliative Medicine Reports |
| Volume: | 5 |
| ISSN: | 2689-2820 |
| Publisher: | Mary Ann Liebert, Inc |
| Date Published: | 2024-01-01 |
| Start Page: | 301 |
| End Page: | 305 |
| Language: | English |
| DOI: | 10.1089/pmr.2023.0089 |
| PROVIDER: | scopus |
| PMCID: | PMC11319851 |
| PUBMED: | 39144131 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK author is Amitabh Gulati -- Source: Scopus |
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