Perret G, McDonnell D
Curr Probl Cancer. 1977 Mar;1(9):1-27. doi: 10.1016/s0147-0272(77)80010-x.
If properly evaluated, the majority of patients with intractable pain caused by visceral as well as somatic malignancy can obtain relief. Analgesics are of great value in some cases. They are especially indicated for patients who have conditions producing pain of short duration or for terminal patients. Radiotherapy may temporarily help most patients with intractable pain. Open or stereotactic surgical intervention and especially interruption of the ascending pain fibers within the spinal cord may give permanent relief to patients who have increasingly severe pain. At present the best results are obtained with percutaneous high cervical electrocoagulation of the spinothalamic tracts. Experience with electrical inhibition of pain based on the gate theory is limited. In the future, however, it may replace the present destructive approaches.
如果评估得当，大多数由内脏及躯体恶性肿瘤引起的顽固性疼痛患者都能得到缓解。镇痛药在某些情况下具有重要价值。它们特别适用于患有短期疼痛病症的患者或晚期患者。放疗可能会暂时帮助大多数顽固性疼痛患者。开放性或立体定向手术干预，尤其是脊髓内上升性痛觉纤维的切断，可能会使疼痛日益严重的患者得到永久性缓解。目前，经皮高颈段脊髓丘脑束电凝术取得了最佳效果。基于闸门理论的疼痛电抑制的经验有限。然而，在未来，它可能会取代目前的破坏性方法。
