Should interventional pain management in patients with pancreatic cancer be guided by tumor localization?

PURPOSE: to investigate the impact of pancreatic cancer localization in relation to the response to different interventional pain management methods and determine the method most suitable for satisfactory pain control.

METHODS

interventional pain management was carried out by sympathetic block or spinal analgesia. Patients were allocated into 2 groups according to the tumor localization, namely group 1 (n=61; patients with pancreatic cancer confined to the head of pancreas), and group 2 (n=55; patients with pancreatic cancer confined to the body or tail of pancreas).

RESULTS

among the patients who had interventional pain management, sufficient analgesia was achieved by sympathetic block in 9 of the 14 (64.3%) of them in group 1 and only in 3 of the 11 (27.3%) patients in group 2. Spinal analgesia was used in 5 of the 14 (35.7%) patients who required interventional pain management in group 1 and in 8 of the 11 (72.7%) patients in group 2 (p>0.05).

CONCLUSION

pain palliation could be achieved by sympathetic block in patients with cancer localized in the head of pancreas while patients with tumor localized in the body and tail experienced sufficient pain palliation by spinal analgesia rather than sympathetic block.