| Citation: |
CHEN Si, SHEN Le. Current Diagnosis and Treatment Status of Pancreatic Cancer Pain[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(4): 884-890. DOI: 10.12290/xhyxzz.2024-0189
|
Pain is one of the most common symptoms in pancreatic cancer patients. Pancreatic cancer-related pain has various sources and complex mechanisms, which seriously affects patients' quality of life and adversely affects their prognosis. Effective pain management may prolong the survival of pancreatic cancer patients. Since the pathogenesis of pancreatic cancer-related pain has not been elucidated, part of the pain management may be based on the mechanism, and part of the pain management may be based on physician's experience only. This article discusses both the pathophysiological classification and treatment strategies of pancreatic cancer-related pain, with the aim of providing reference for clinical analgesic practice in pancreatic cancer.
| [1] |
Westermann A, Matrisian L M, Rahib L. The need for improvement in the management of fatigue, depression and pain in pancreatic cancer[J]. J Clin Oncol, 2019, 37(S4): 429.
|
| [2] |
McNearney T A, Digbeu B D E, Baillargeon J G, et al. Pre-diagnosis pain in patients with pancreatic cancer signals the need for aggressive symptom management[J]. Oncologist, 2023, 28(12): e1185-e1197. DOI: 10.1093/oncolo/oyad153
|
| [3] |
Grossberg A J, Chu L C, Deig C R, et al. Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma[J]. CA Cancer J Clin, 2020, 70(5): 375-403. DOI: 10.3322/caac.21626
|
| [4] |
Damm M, Weniger M, Kölsch A K, et al. The quality of pain management in pancreatic cancer: a prospective multi-center study[J]. Pancreatology, 2020, 20(7): 1511-1518. DOI: 10.1016/j.pan.2020.08.017
|
| [5] |
Ozcan S, Akin S, Yildiz Altun A, et al. Effective pain therapy can improve the survival of patients with pancreatic cancer[J]. Agri, 2019, 31(3): 145-149.
|
| [6] |
Wu M J, Zhu A F, Shen L. Pancreatic cancer-related pain: mechanism and management[J]. J Pancreatol, 2023, 6(4): 202-209.
|
| [7] |
Coveler A L, Mizrahi J, Eastman B, et al. Pancreas cancer-associated pain management[J]. Oncologist, 2021, 26(6): e971-e982. DOI: 10.1002/onco.13796
|
| [8] |
Thottungal A, Kumar P, Bhaskar A. Interventions for myofascial pain syndrome in cancer pain: recent advances: why, when, where and how[J]. Curr Opin Support Palliat Care, 2019, 13(3): 262-269.
|
| [9] |
Moffat G T, Epstein A S, O'Reilly E M. Pancreatic cancer-a disease in need: optimizing and integrating supportive care[J]. Cancer, 2019, 125(22): 3927-3935. DOI: 10.1002/cncr.32423
|
| [10] |
WHO. WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents[M]. Geneva: World Health Organization, 2018.
|
| [11] |
Tung S, Coburn N G, Davis L E, et al. Population-based study of the prevalence and management of self-reported high pain scores in patients with non-resected pancreatic adenocarcinoma[J]. Br J Surg, 2019, 106(12): 1666-1675. DOI: 10.1002/bjs.11330
|
| [12] |
Zylberberg H M, Woodrell C, Rustgi S D, et al. Opioid prescription is associated with increased survival in older adult patients with pancreatic cancer in the United States: a propensity score analysis[J]. JCO Oncol Pract, 2022, 18(5): e659-e668. DOI: 10.1200/OP.21.00488
|
| [13] |
Steele G L, Dudek A Z, Gilmore G E, et al. Impact of pain, opioids, and the mu-opioid receptor on progression and survival in patients with newly diagnosed stage IV pancreatic cancer[J]. Am J Clin Oncol, 2020, 43(8): 591-597. DOI: 10.1097/COC.0000000000000714
|
| [14] |
Kajiwara I, Sano M, Ichimaru Y, et al. Duloxetine improves cancer-associated pain in a mouse model of pancreatic cancer through stimulation of noradrenaline pathway and its antitumor effects[J]. Pain, 2020, 161(12): 2909-2919. DOI: 10.1097/j.pain.0000000000001997
|
| [15] |
Lee K G, Roy V, Laszlo M, et al. Symptom management in pancreatic cancer[J]. Curr Treat Options Oncol, 2021, 22(1): 8. DOI: 10.1007/s11864-020-00801-4
|
| [16] |
Dai J Z, Teng L, Zhao L Y, et al. The combined analgesic effect of pregabalin and morphine in the treatment of pancreatic cancer pain, a retrospective study[J]. Cancer Med, 2021, 10(5): 1738-1744. DOI: 10.1002/cam4.3779
|
| [17] |
Itaya T, Sano M, Kajiwara I, et al. Mirogabalin improves cancer-associated pain but increases the risk of malignancy in mice with pancreatic cancer[J]. Pain, 2023, 164(7): 1545-1554. DOI: 10.1097/j.pain.0000000000002852
|
| [18] |
Barnes A F, Yeo T P, Leiby B, et al. Pancreatic cancer-associated depression: a case report and review of the literature[J]. Pancreas, 2018, 47(9): 1065-1077. DOI: 10.1097/MPA.0000000000001148
|
| [19] |
Zhang H, Yang L, Zhu X, et al. Association between intraoperative intravenous lidocaine infusion and survival in patients undergoing pancreatectomy for pancreatic cancer: a retrospective study. Br J Anaesth 2020; 125: 141e8.
|
| [20] |
Liu C, Yu M, Li Y, et al. Lidocaine inhibits the metastatic potential of ovarian cancer by blocking NaV 1.5-mediated EMT and FAK/Paxillin signaling pathway. Cancer Med 2021; 10: 337e49.
|
| [21] |
Zhang H, Qu M D, Guo K F, et al. Intraoperative lidocaine infusion in patients undergoing pancreatectomy for pancreatic cancer: a mechanistic, multicentre randomised clinical trial[J]. Br J Anaesth, 2022, 129(2): 244-253. DOI: 10.1016/j.bja.2022.03.031
|
| [22] |
Lin K J, Hsu F K, Shyr Y M, et al. Effect of epidural analgesia on long-term outcomes after curative surgery for pancreatic cancer: A single-center cohort study in Taiwan[J]. J Chin Med Assoc, 2022, 85(1): 124-128. DOI: 10.1097/JCMA.0000000000000615
|
| [23] |
Maker A V. ASO author reflections: how can we improve the postoperative experience for our pancreatic cancer patients? A practical technique to optimize pain control after major abdominal surgery[J]. Ann Surg Oncol, 2021, 28(4): 2296-2298. DOI: 10.1245/s10434-020-09092-3
|
| [24] |
Vahedian J, Saraee A, Baghai Wadji M, et al. Corrigendum to "pain relieving effect of intraoperative chemical splanchnicectomy of celiac ganglions in patients with resectable pancreatic or gastric masses: a randomized clinical trial"[J]. Pain Res Manag, 2021, 2021: 9536729.
|
| [25] |
Saletta G A, Sprott H. Bedside neurolysis for palliative care of critically ill patients with pancreatic cancer[J]. J Ultrasound Med, 2019, 38(7): 1907-1911. DOI: 10.1002/jum.14881
|
| [26] |
Vig S, Bhan S, Bhatnagar S. Celiac plexus block-an old technique with new developments[J]. Pain Physician, 2021, 24(5): 379-398.
|
| [27] |
谢广伦, 郭大鹏, 刘畅, 等. 腹腔神经丛毁损单独或联合腹膜后转移淋巴结注射治疗胰腺癌相关疼痛的效果比较[J]. 中华医学杂志, 2020, 100(5): 357-362. DOI: 10.3760/cma.j.issn.0376-2491.2020.05.008
Xie G L, Guo D P, Liu C, et al. Comparison of effects of celiac plexus block alone or in combination with retroperitoneal metastatic lymph node injection for pancreatic cancer-related pain[J]. Natl Med J China, 2020, 100(5): 357-362. DOI: 10.3760/cma.j.issn.0376-2491.2020.05.008
|
| [28] |
Urits I, Jones M R, Orhurhu V, et al. A comprehensive review of the celiac plexus block for the management of chronic abdominal pain[J]. Curr Pain Headache Rep, 2020, 24(8): 42. DOI: 10.1007/s11916-020-00878-4
|
| [29] |
Wyse J M, Sahai A V. EUS-guided celiac plexus neurolysis for pancreas cancer-Finally established or still under review?[J]. Best Pract Res Clin Gastroenterol, 2022, 60/61: 101809. DOI: 10.1016/j.bpg.2022.101809
|
| [30] |
Li M, Wang Z H, Chen Y, et al. EUS-CGN versus EUS-CPN in pancreatic cancer: a qualitative systematic review[J]. Medicine (Baltimore), 2021, 100(41): e27103. DOI: 10.1097/MD.0000000000027103
|
| [31] |
Kamata K, Kinoshita M, Kinoshita I, et al. Efficacy of EUS-guided celiac plexus neurolysis in combination with EUS-guided celiac ganglia neurolysis for pancreatic cancer-associated pain: a multicenter prospective trial[J]. Int J Clin Oncol, 2022, 27(7): 1196-1201. DOI: 10.1007/s10147-022-02160-6
|
| [32] |
Ye L H, Schorn S, Pergolini I, et al. The effect of celiac neurolysis and splanchnicectomy on survival in unresectable pancreatic cancer: a systematic review and meta-analysis[J]. Dig Surg, 2022, 39(1): 51-59. DOI: 10.1159/000520456
|
| [33] |
Han C Q, Tang X L, Zhang Q, et al. Predictors of pain response after endoscopic ultrasound-guided celiac plexus neurolysis for abdominal pain caused by pancreatic malignancy[J]. World J Gastroenterol, 2021, 27(1): 69-79. DOI: 10.3748/wjg.v27.i1.69
|
| [34] |
Filippiadis D, Ptohis N, Efthymiou E, et al. A technical report on the performance of percutaneous cryoneurolysis of splanchnic nerves for the treatment of refractory abdominal pain in patients with pancreatic cancer: initial experience[J]. Cardiovasc Intervent Radiol, 2021, 44(5): 789-794. DOI: 10.1007/s00270-020-02756-3
|
| [35] |
Uehara Y, Matsumoto Y, Kosugi T, et al. Availability of and factors related to interventional procedures for refractory pain in patients with cancer: a nationwide survey[J]. BMC Palliat Care, 2022, 21(1): 166. DOI: 10.1186/s12904-022-01056-6
|
| [36] |
Koulouris A I, Banim P, Hart A R. Pain in patients with pancreatic cancer: prevalence, mechanisms, management and future developments[J]. Dig Dis Sci, 2017, 62(4): 861-870. DOI: 10.1007/s10620-017-4488-z
|
| [37] |
Ebrahimi G, Rasch C R N, Van Tienhoven G. Pain relief after a short course of palliative radiotherapy in pancreatic cancer, the Academic Medical Center (AMC) experience[J]. Acta Oncol, 2018, 57(5): 697-700. DOI: 10.1080/0284186X.2017.1400692
|
| [38] |
Tello Valverde C P, Ebrahimi G, Sprangers M A, et al. Impact of short-course palliative radiation therapy on pancreatic cancer-related pain: prospective phase 2 nonrandomized PAINPANC trial[J]. Int J Radiat Oncol Biol Phys, 2024, 118(2): 352-361. DOI: 10.1016/j.ijrobp.2023.08.055
|
| [39] |
Liu A K N, Lefresne S. Palliative radiotherapy in pancreatic cancer: a retrospective study of 100 cases and regional patterns of practice[J]. Ann Palliat Med, 2023, 12(5): 891-899. DOI: 10.21037/apm-22-1417
|
| [40] |
Buwenge M, Macchia G, Arcelli A, et al. Stereotactic radiotherapy of pancreatic cancer: a systematic review on pain relief[J]. J Pain Res, 2018, 11: 2169-2178. DOI: 10.2147/JPR.S167994
|
| [41] |
Qian C, Wan L I, Wu Y K. Analysis of the results of high-intensity focused ultrasound for patients with advanced pancreatic cancer[J]. Int J Hyperthermia, 2023, 40(1): 2250586. DOI: 10.1080/02656736.2023.2250586
|
| [42] |
Marinova M, Feradova H, Gonzalez-Carmona M A, et al. Improving quality of life in pancreatic cancer patients following high-intensity focused ultrasound (HIFU) in two European centers[J]. Eur Radiol, 2021, 31(8): 5818-5829. DOI: 10.1007/s00330-020-07682-z
|
| [43] |
Yang Y, Shi X Q, Chen G, et al. Risk factors for unresectable pancreatic cancer following high-intensity focused ultrasound treatment[J]. Cancer Med, 2023, 12(19): 19537-19547. DOI: 10.1002/cam4.6568
|
| [44] |
Thudium M, Bette B, Tonguc T, et al. Multidisciplinary management and outcome in pancreatic cancer patients treated with high-intensity focused ultrasound[J]. Int J Hyperthermia, 2020, 37(1): 456-462.
|
| [45] |
Carvajal G, Dupoiron D, Seegers V, et al. Intrathecal drug delivery systems for refractory pancreatic cancer pain: observational follow-up study over an 11-year period in a comprehensive cancer center[J]. Anesth Analg, 2018, 126(6): 2038-2046.
|
| [46] |
赵睿, 杨立强. 鞘内药物输注设备治疗癌痛的适应证及注意事项[J]. 中国全科医学, 2020, 23(23): 2975-2980. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202023017.htm
Zhao R, Yang L Q. Indications and precautions of intrathecal drug infusion devices for the treatment of cancer pain[J]. Chin Gen Pract, 2020, 23(23): 2975-2980. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202023017.htm
|
| [47] |
李琳, 冯智英. 鞘内药物输注治疗中重度癌痛的研究进展[J]. 中华医学杂志, 2021, 101(43): 3604-3608.
Li L, Feng Z Y. Research progress on intrathecal drug infusion for the treatment of moderate to severe cancer pain[J]. Natl Med J China, 2021, 101(43): 3604-3608.
|
| [48] |
章沿锋, 冯智英. 半植入式鞘内药物输注系统长期治疗难治性癌痛: 1例报道及文献复习[J]. 中华疼痛学杂志, 2023, 19(4): 642-646. https://www.cnki.com.cn/Article/CJFDTOTAL-SGKZ202407019.htm
Zhang Y F, Feng Z Y. Long term treatment of refractory cancer pain with half-implanted intrathecal drug delivery systems: a case report and literature review[J]. Chin J Painol, 2023, 19(4): 642-646. https://www.cnki.com.cn/Article/CJFDTOTAL-SGKZ202407019.htm
|
| [49] |
Carvajal G. Pancreatic cancer related pain: review of pathophysiology and intrathecal drug delivery systems for pain management[J]. Pain Physician, 2021, 24(5): E583-E594.
|
| [50] |
Morag O, Shalit N. Trigger point dry needling to address testicular pain of a pancreatic cancer patient[J]. J Pain Symptom Manage, 2021, 62(1): e1-e3.
|
| [51] |
He L H, Tan K P, Lin X M, et al. Multicenter, randomized, double-blind, controlled trial of transcutaneous electrical nerve stimulation for pancreatic cancer related pain[J]. Medicine (Baltimore), 2021, 100(5): e23748.
|
| [52] |
Tarasiuk A, Mirocha G, Fichna J. Current status of complementary and alternative medicine interventions in the management of pancreatic cancer-an overview[J]. Curr Treat Options Oncol, 2023, 24(12): 1852-1869.
|
| [53] |
Eggers C, Olliges E, Boeck S, et al. Exploring pain, quality of life, and emotional well-being in patients with advanced pancreatic cancer practicing spiritual meditation: a pilot study[J]. Complement Med Res, 2023, 30(4): 289-298.
|
| [54] |
Frenkel M, David A, Sapire K, et al. Complementary and integrative medicine in pancreatic cancer[J]. Curr Oncol Rep, 2023, 25(3): 231-242.
|
| [55] |
Lohse I, Brothers S P. Pathogenesis and treatment of pancreatic cancer related pain[J]. Anticancer Res, 2020, 40(4): 1789-1796.
|
| [1] | ZHAO Yizhou, LI Jianing, WANG Qiang, WU Dongsheng, ZHANG Shengyu, WU Xi, GUO Tao, JIANG Qingwei, YANG Yingyun, SHI Wen, FENG Yunlu, YANG Aiming. The Efficacy of Combined Endoscopic Ultrasound Fine-needle Aspiration and Endoscopic Retrograde Cholangiopancreatography in Same Session for the Diagnosis and Management of Pancreatic Carcinoma with Obstructive Jaundice[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(4): 819-824. DOI: 10.12290/xhyxzz.2024-0207 |
| [2] | LUO Fuchao, ZHANG Junhua, CHENG Peng, WU Jing, ZHONG Bin, LYU Bing, HUANG Guogang, LIU Yang, ZHANG Zexue, WEI Xiaohong. Clinical Application of Ultrasound-guided RISS Plane Block for Postoperative Analgesia After Minimally Invasive McKeown Esophagectomy: A Prospective Randomized Controlled Study[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 624-631. DOI: 10.12290/xhyxzz.2023-0358 |
| [3] | WU Chen, ZHANG Li, MA Chao, LIU Hongju, LIU Xuming, ZHANG Kepu, WANG Tengti. Advances of Virtual Reality in the Field of Pain Treatment[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(2): 272-278. DOI: 10.12290/xhyxzz.2023-0519 |
| [4] | Joint Surgery Branch of Chinese Orthopaedic Association, Joint Surgery Branch of Beijing Orthopaedic Association. Guidelines for Perioperative Pain Management in Total Knee Arthroplasty in China (2022)[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(6): 965-985. DOI: 10.12290/xhyxzz.2022-0642 |
| [5] | Wen-liang SU, Lu-lu MA, Xiu-hua ZHANG, Yu-guang HUANG. Advances in the Mechanisms of Pain Associated with Endometriosis[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(4): 439-442. DOI: 10.3969/j.issn.1674-9081.2020.04.014 |
| [6] | Hong Yang, Shanshan Hu, Gechong Ruan, Xiaoou Yang, Jiaming Qian. Expression of ARHI and HuR in PANC-1 Cells[J]. Medical Journal of Peking Union Medical College Hospital, 2017, 8(1): 39-42. DOI: 10.3969/j.issn.1674-9081.2017.01.009 |
| [8] | Xiao-hua SHI, Zhi-yong LIANG, Huan-wen WU, Xin-yu REN, Tong-hua LIU. Effect of RNA Interference Plasmid on the Expression of Oncogene AKT2 in Pancreatic Cancer Cell Line Panc-1[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(1): 102-108. DOI: 10.3969/j.issn.1674-9081.2012.01.021 |
| [9] | Xin-yu REN, Yu-feng YIN, Jie GAO, Sha-fei WU, Ke WANG, Wen-ze WANG, Xuan ZENG, Zhi-yong LIANG. Detection of HER2/neu Gene in Pancreatic and Gastric Adenocarcinoma among Chinese Patients[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(1): 21-25. DOI: 10.3969/j.issn.1674-9081.2012.01.006 |
| [10] | Nai-xin LIANG, Fan ZHANG, Cheng HUANG, Ying-zhi QIN, Hong-sheng LIU, Shan-qing LI. Comparison of Intercostal Nerve Cryoanalgesia and Patient-controlled Analgesia for Early Post-thoracotomy Pain Control[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(1): 37-41. DOI: 10.3969/j.issn.1674-9081.2011.01.008 |
Supported by: Beijing Renhe Information Technology Co., Ltd. 
Submit
Review
Office
Email Alert
RSS
DownLoad: