Liu Shangang, Fu Weiwei, Liu Zengjun, Liu Ming, Ren Ruimei, Zhai Huaxu, Li Chengli
Department of Medical Oncology, Fourth People's Hospital of Zibo City, The affiliated Hospital of Shandong Cancer Hospital and Institute, Zibo, China.
Department of Medical Oncology, Shandong Cancer Hospital and Institute, Jinan, China.
J Magn Reson Imaging. 2016 Oct;44(4):923-8. doi: 10.1002/jmri.25246. Epub 2016 Mar 28.
To prospectively determine the efficacy and safety of magnetic resonance imaging (MRI)-guided celiac plexus neurolysis (CPN) for pancreatic cancer pain.
In all, 39 patients with pancreatic cancer underwent 0.23T MRI-guided CPN with ethanol via the posterior approach. The pain relief, the opioid intake, and pain interference with appetite, sleep, and communication in patients were assessed after CPN during a 4-month follow-up period. The complications were also evaluated during or after CPN.
CPN procedures were successfully completed for all patients. Minor complications included diarrhea (9 of 39; 23.1%), orthostatic hypotension (14 of 39; 35.9%), and local backache (20 of 39; 51.3%). No major complication occurred. Pain relief was observed in 36 (92.3%), in 15 (40.5%), and in 11 (35.5%) patients at 1-, 2-, and 3-month visits, respectively. The median duration of pain relief was 2.9 months (95% confidence interval [CI], 2.4-3.4). The opioid intake significantly decreased at the 1-, 2-, and 3-month visits (P < 0.001, < 0.001, = 0.001 respectively), and there was significant improvement in sleep at the 1-, 2-, and 3-month visits (P < 0.001, < 0.001, = 0.001 respectively), and appetite and communication were significantly improved at the 1- and 2-month visits (all P < 0.001); all compared with baseline.
MRI-guided CPN appears to be an effective and minimally invasive procedure for palliative pain management of pancreatic cancer. J. MAGN. RESON. IMAGING 2016;44:923-928.
前瞻性地确定磁共振成像（MRI）引导下腹腔神经丛毁损术（CPN）治疗胰腺癌疼痛的疗效和安全性。
共有39例胰腺癌患者接受了0.23T MRI引导下经后路乙醇注射CPN。在CPN术后4个月的随访期内，评估患者的疼痛缓解情况、阿片类药物摄入量以及疼痛对食欲、睡眠和交流的影响。同时在CPN术中及术后评估并发症情况。
所有患者的CPN手术均成功完成。轻微并发症包括腹泻（39例中的9例；23.1%）、体位性低血压（39例中的14例；35.9%）和局部背痛（39例中的20例；51.3%）。未发生严重并发症。分别在1个月、2个月和3个月的随访时，观察到36例（92.3%）、15例（40.5%）和11例（35.5%）患者疼痛缓解。疼痛缓解的中位持续时间为2.9个月（95%置信区间[CI]，2.4 - 3.4）。在1个月、2个月和3个月的随访时，阿片类药物摄入量显著减少（分别为P < 0.001、< 0.001、 = 0.001），在1个月、2个月和3个月的随访时睡眠有显著改善（分别为P < 0.001、< 0.001、 = 0.001），在1个月和2个月的随访时食欲和交流有显著改善（均为P < 0.001）；所有均与基线相比。
MRI引导下的CPN似乎是一种治疗胰腺癌姑息性疼痛的有效且微创的方法。《磁共振成像杂志》2016年；44:923 - 928。
