EUS-Coeliac Plexus Block Versus Radiofrequency Ablation in Pain Relief of Patients With Malignancy

  • STATUS
    Recruiting
  • End date
    Jan 31, 2024
  • participants needed
    54
  • sponsor
    The University of Hong Kong
Updated on 1 April 2021

Summary

Many cancer patients suffer from intractable pain and which is often suboptimally controlled by even strong opioid analgesics. Coeliac plexus neurolysis (CPN) is procedure which intended to permanently destroy the nociceptive pathway that transmits the pain caused by the tumour. It can be with different approaches, such as percutaneously guided by fluoroscopy, echo-endoscopically or surgically with endoscopic approach being the more popular one in many centers equipped with echo-endoscopic services. The effect of CPN has been well established by some retrospective series. The overall response rate to CPN ranges from 70-90%, however, the analgesic effect is limited and up to roughly around 3 months. It is believed that the short-lasting analgesic effect is related to incomplete neurolysis by absolute alcohol injection.

Recently, radiofrequency ablation (RFA) of coeliac plexus has been introduced as another mode of CPN. So far, only one small single center randomized controlled trial (RCT) suggesting superior performance in favour to CPN using RFA. This result has to be validated and by a RCT with larger sample size. In addition, data concerning the quality of life (QOL) improvement and cost-effectiveness need to be further elucidated. Therefore, the aim of this study is to perform a RCT to look into these issues.

Description

The aim of this study is to compare the efficacy of EUS-guided CPN versus radiofrequency ablation in patients with pain related to pancreatic cancer. By performing a randomized controlled trial, the clinical outcomes and cost-effectiveness of this new RFA treatment approach can be evaluated.

Details
Condition Pancreatic Cancer, Pancreatic Cancer, Islet Ce417ll Cancer, Analgesia, Pancreatic disorder, Pancreatic Disorders, Neoplasm of unspecified nature of digestive system, Digestive System Neoplasms, Pain, Post-Surgical Pain, Pain (Pediatric), Pain, Acute Pain Service, Pancreatic Disorders, Post-Surgical Pain, Cancer Pain, Cancer Pain, Pain (Pediatric), Islet Ce417ll Cancer, Digestive System Neoplasms, pain management, pain control, pain relieving, managed pain, pain therapy, ache, cancer of the pancreas, pancreatic neoplasm, pancreatic cancers, cancer, pancreatic
Treatment 98% dehydrated alcohol, 19G EUSRA needle, Taewoong Medical, Korea
Clinical Study IdentifierNCT04809935
SponsorThe University of Hong Kong
Last Modified on1 April 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Age 18 year-old
Patients who give informed consent to the study
Suboptimal pain control with regular analgesics
Inoperable cancer of pancreas

Exclusion Criteria

Patients who refuse to give consent
Patients aged <18 years
EUS not possible due to
Problem related to scope insertion such as trismus, stenosis of the upper GI
tract Coagulopathy with INR >1.5 or platelet count < 70
Low oxygen saturation or extreme blood pressure render endoscopic procedure unsafe
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