Aims and objectives
Cancer pain can be effectively managed in about 90% of patients with stepwise use of the WHO analgesic ladder system (1)
80% of the patients with cancer their pain is often severe enough that treatment with opioid analgesics is required.
(2)
Although there has been progress in the management of cancer-related pain,
the current treatments still have negative effects on quality of life and survival rates(3)
Pain related to the cancer can be caused by a direct mass effect of the tumor,
which compresses or...
Methods and materials
18 patients diagnosed with inoperable locally advanced pancreatic cancer ,
8 patients with hepatic malignancies reaching the liver capsule,
(size range 2-5 cm ),
2 patients with aggressive fibromatosis in the lower limbs , 2 patients with retroperitoneal malignant masses (leiomyosarcoma and metastatic lymph nodes ,
1 patient with hemipelvic bony metastatic cancer breast ,
2 patients with metastatic rib from HCC,
6 patients with adenomyosis (2 focal ,
4 diffuse) .
They all underwent US guided HIFU treatment aiming control of pain .
HIFU...
Results
Overall reduction of the pain Visual Analogue scale score,
daily morphine consumption,
Oswestry Disability Index score,
and Patient’s Global Impression of Change score before and 1 week,
4 weeks,
and 12 weeks after the procedure
In cases of adenomyosis 2 sessions were required to alleviate of the pain ,
with mean interval 10 weeks,
reached the maximum effect of pain relief after mean 12 weeeks after the end of treatment.
Complication rate : 0%
Conclusion
US HIFU is safe and efficient in pain control of neoplastic and non neoplastic lesions
References
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Gonin R,
Hatfield AK,
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Blum RH,
Stewart JA,
Pandya KJ,
et al.
Pain and its treatment in outpatients with metastatic cancer.
N Engl J Med 1994;330:592–596
2.
McGuire DB.
Occurrence of cancer pain.
J Natl Cancer Inst Monogr 2004;2004(32):51–56
3.Mantyh PW.
Cancer pain and its impact on diagnosis,
survival and quality of life.
Nat Rev Neurosci 2006;7(10):797–809.
4.
Brown MR,
Ramirez JD.
Neuroimmune mechanisms in cancer pain.
Curr Opin Support Palliat Care 2015;9(2):103–111.
5.
Hui D,
Bruera E.
A personalized approach...