ABSTRACT
Background: since cancer-associated pain is a common occurrence in malignancies involving the chest. In these cases, pain is complex and may have visceral, somatic or neuropathic components. It has been noticed that the number of cancer patients with refractory chest pain is increasing with more cancer prevalence, also with the advances in therapy and prolonged life expectancy. The demand for interventional procedures to control pain for these patients also increases. Interventional pain procedures are indicated for refractory pain when analgesic drugs are ineffective or associated with intolerable side effects. In controlling cancer pain it is commonly inadequately managed for these patients leading to suffer form of physical disabilities, psychological disturbance and avoiding treatment
Aim of the work: this study was designed to test both the efficacy and safety of thermo-coagulative ablation of the thoracic dorsal root ganglia for pain control in cancer patients that have refractory chest pain
Methodology: this prospective randomized study was conducted in the National Cancer Institute, Cairo University and Aswan University after board approval from October 2016 to March 2018. Sixty-five patients with Refractory Chronic Chest Cancer Pain were selected randomly and prospectively from the pain clinic of both the National Cancer Institute of Cairo University and Aswan University, after taken an informed written consent from the patient. The complete duration of the follow up lasted 3 months post-interventional with assessments after 1 week, 1 month and 3 months. At each follow up each patient was re-assessed with the following assessments; VAS, ECOG Performance Status
Results: we found that with effective pain relief there was a significant reduction in the mean VAS values; which means that there was functional improvement, in all the post-interventional follow ups. Also, there was an improvement in the functional state of the patients throughout the follow-up post-intervention with regards to the ECOG performance status from the results
Conclusion: we concluded that thermal radiofrequency ablation is considered an alternative for treating refractory chronic chest cancer pain of several types and causes. This is because of its efficacy, safety and ease of use. It also requires a minimal hospital stay or can even be performed on an outpatient basis
ABSTRACT
Background: in controlling cancer pain it is commonly inadequately managed for these patients leading to suffer in the form of physical disabilities, psychological disturbance, avoiding treatment. Therefore pain that is caused by cancer may directly affect the patient's quality of life; by having an effect on his/her daily activity, physical state and also psychological and emotional status. Thus, making pain relief and control the patient's right; right for a new life "pain free" or at least tolerable non-disabling pain
Aim of the work: this study aimed to test both the efficacy and safety of thermo-coagulative ablation of the thoracic dorsal root ganglia for pain control in cancer patients that have refractory chest pain And the impact on quality of life for patients
Patients and Methods: our prospective study was done on sixty-five patients selected from pain clinics of both the National Institute of Cancer, Cairo University and Aswan University with refractory chronic chest cancer pain according to the inclusion and exclusion criteria. The complete duration of the follow up lasted 3 months postinterventional; with assessments after 1 week, 1 month and 3 months. At each follow up each patient was reassessed with the following assessments; VAS, ECOG performance status, QOLS, drug consumption, side-effects [complications] and patient satisfaction
Results: we found that with effective pain relief there was a significant reduction in the mean VAS values which means that there was functional improvement, in all the postinterventional follow ups. Also, there was an improvement in the functional state of the patients throughout the follow-up post-intervention with regardsto the ECOG performance statusfrom the results. In addition to the ECOG improvement there was also a significant improvement in the QOL [Quality of Life] results, which was due to the pain relief. Regarding drug consumption, it was recorded that all three drugs; pregabalin, oxycodone and amitryptline, should maximum reduction after 1 month following the intervention, with a slight increase 3 months post-interventional, which matched the degree of pain reduction based on the pain scaling scores. Only 11% of our patients were found with numbness and neuritis, which were the only two complications reported. With regards to our patients, 30.6% certainly would repeat the procedure, 54.8% probably would, and 12.9 % probably would not while, only 1.6% certainly would not repeat it. With25.8% certainly would recommend the same procedure, 56.5% probably would, 14.5% probably would not and only 3.2% certainly would not recommend it
Conclusion: we concluded that thermal radiofrequency ablation is considered an alternative for treating refractory chronic chest cancer pain of several types and causes. This is because of its efficacy, safety and ease of use, patient's quality of life of was largely affected