Cascella Marco, Muzio Maria Rosaria, Viscardi Daniela, Cuomo Arturo
1 Department of Anestesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy.
2 Division of Infantile Neuropsychiatry, UOMI-Maternal and Infant Health, Azienda Sanitaria Locale Napoli 3 Sud, Naples, Italy.
Am J Hosp Palliat Care. 2017 Jul;34(6):524-531. doi: 10.1177/1049909116636374. Epub 2016 Mar 2.
Pain is a common and debilitating symptom in pelvic cancer diseases. Failure in controlling this pain through pharmacological approaches calls for employing multimodal management and invasive techniques. Various strategies are commonly used for this purpose, including palliative radiotherapy, epidural medications and intrathecal administration of analgesic and local anesthetic drugs with pumps, and neural or plexus blockade. This review focuses on the features of minimally invasive palliative procedures (MIPPs), such as radiofrequency ablation, laser-induced thermotherapy, cryoablation, irreversible electroporation, electrochemotherapy, microwave ablation, and cementoplasty as well as their role in palliation of cancer pelvic pain. Despite the evidence of effectiveness and safety of these interventions, there are still many barriers to accessing MIPPs, including the availability of trained staff, the lack of precise criteria of indication, and the high costs.
疼痛是盆腔癌疾病中常见且使人衰弱的症状。通过药物方法控制这种疼痛的失败促使采用多模式管理和侵入性技术。为此通常使用各种策略，包括姑息性放疗、硬膜外用药以及使用泵鞘内注射镇痛药和局部麻醉药，还有神经或神经丛阻滞。本综述重点关注微创姑息治疗程序（MIPP）的特点，如射频消融、激光诱导热疗、冷冻消融、不可逆电穿孔、电化学疗法、微波消融和骨水泥成形术，以及它们在缓解癌性盆腔疼痛中的作用。尽管有证据表明这些干预措施有效且安全，但获得MIPP仍存在许多障碍，包括训练有素的工作人员的可用性、缺乏精确的适应症标准以及成本高昂。
