Pancreatic cancer is an aggressive tumor associated with high mortality. Optimal pain control may improve quality of life (QOL) for patients with pancreatic cancer.
In this study, physicians from the United States evaluated neurolytic celiac plexus block (NCPB) versus opioids alone in the pain relief, QOL, and survival.
The team performed a clinical trial at the Mayo Clinic, Rochester, Minnesota.
They included 100 patients with unresectable pancreatic cancer experiencing pain.
Patients were followed for 1 year or until death.
|Patients in the NCPB group experienced a greater decrease in pain.|
|Journal of the American Medical Association|
The physicians randomized the patients to receive either NCPB or systemic analgesic therapy alone with a sham injection.
All patients could receive additional opioids managed by a clinician blinded to the patient's treatment.
The team measured pain intensity, QOL, opioid consumption and related adverse effects, and survival.
The physicians established that mean baseline pain was 4.4 for patients in the NCPB group versus 4.1 for opioids alone.
They found that in the first week of the study, pain intensity and QOL scores improved. Patients in the NCPB group experienced a greater decrease in pain.
Using repeated measures analysis, the team established that pain was lower for the NCPB group over time.
However, opioid consumption, frequency of opioid adverse effects, and QOL were not significantly different between the groups.
The team found that in the first 6 weeks, fewer NCPB patients reported moderate or severe pain compared to the opioid-only patients.
They found that at 1 year, 16% of NCPB patients and 6% of opioid-only patients were alive. However, survival did not differ significantly between the groups.
Dr Gilbert Wong and colleagues concluded, "Although NCPB improves pain relief in patients with pancreatic cancer versus optimized systemic analgesic therapy alone, it does not affect QOL or survival".