Nuffield Department of Clinical Sciences, John-Radcliffe Hospital, OX3 9DU Oxford, United Kingdom; The Royal Free London NHS Foundation Trust, London, United Kingdom.
Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St George's University of London, London, United Kingdom.
Neurochirurgie. 2021 Apr;67(2):176-188. doi: 10.1016/j.neuchi.2020.10.003. Epub 2020 Oct 29.
Cancer pain is common and challenging to manage - it is estimated that approximately 30% of cancer patients have pain that is not adequately controlled by analgesia. This paper discusses safe and effective neuroablative treatment options for refractory cancer pain. Current management of cancer pain predominantly focuses on the use of medications, resulting in a relative loss of knowledge of these surgical techniques and the erosion of the skills required to perform them. Here, we review surgical methods of modulating various points of the neural axis with the aim to expand the knowledge base of those managing cancer pain. Integration of neuroablative approaches may lead to higher rates of pain relief, and the opportunity to dose reduce analgesic agents with potential deleterious side effects. With an ever-increasing population of cancer patients, it is essential that neurosurgeons maintain or train in these techniques in tandem with the oncological multi-disciplinary team.
癌症疼痛很常见，也很难控制——据估计，大约 30%的癌症患者存在疼痛，而这些疼痛无法通过镇痛来充分控制。本文讨论了针对难治性癌症疼痛的安全有效的神经消融治疗选择。目前癌症疼痛的主要治疗方法侧重于药物治疗，这导致了人们对这些手术技术的相对了解不足，以及进行这些手术所需技能的丧失。在这里，我们回顾了调节神经轴各个点的手术方法，旨在扩大管理癌症疼痛的人员的知识库。神经消融方法的整合可能会导致更高的疼痛缓解率，并有可能减少具有潜在有害副作用的镇痛药物的剂量。随着癌症患者人数的不断增加，神经外科医生与肿瘤多学科团队一起保持或培训这些技术至关重要。
