Details

Autor(en) / Beteiligte

• Kamata, Ken
• Kinoshita, Makiko
• Kinoshita, Ikuharu
• Imai, Hajime
• Ogura, Takeshi
• Matsumoto, Hisakazu
• Minaga, Kosuke
• Chiba, Yasutaka
• Takenaka, Mamoru
• Kudo, Masatoshi
• Kitano, Masayuki

Titel

Efficacy of EUS-guided celiac plexus neurolysis in combination with EUS-guided celiac ganglia neurolysis for pancreatic cancer-associated pain: a multicenter prospective trial

Ist Teil von

• International journal of clinical oncology, 2022-07, Vol.27 (7), p.1196-1201

Ort / Verlag

Singapore: Springer Nature Singapore

Erscheinungsjahr

2022

Quelle

SpringerLink

Beschreibungen/Notizen

• Objectives This study evaluated the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in combination with EUS-guided celiac ganglia neurolysis (EUS-CGN) for pancreatic cancer-associated pain. Methods This multicenter prospective trial was registered in the University Hospital Medical Information Network (UMIN000031228). Fifty-one consecutive patients with pancreatic cancer-associated pain who presented at one of five Japanese referral centers between February 2018 and March 2021 were enrolled. EUS-CGN was added in cases of visible celiac ganglia. The primary endpoint was effectiveness, defined as a decrease in the numerical rating scale (NRS) by ≥ 3 points. NRS data were prospectively acquired at 1 week after the procedure to evaluate its effectiveness and the extent of pain relief. Results The technical success rates of EUS-CPN and EUS-CGN were 100% and 80.4%, respectively. The overall efficacy rate was 82.4% [90% confidence interval (CI) 71.2–90.5, P  < 0.0001]. The complete pain relief rate was 27.4%. The adverse events rate was 15.7%. The average pain relief period was 72 days. The efficacy rate was higher in the EUS-CPN plus EUS-CGN group than in the EUS-CPN alone group. EUS-CPN plus EUS-CGN was superior to EUS-CPN alone for achieving complete pain relief ( P  = 0.045). EUS-CGN did not improve the average length of the pain relief period. Conclusions EUS-CPN combined with EUS-CGN is safe, feasible, and effective for pain relief in patients with pancreatic cancer. The patients who received additional EUS-CGN had a better short-term response. Clinical trial number UMIN000031228.