Percutaneous cervical cordotomy for cancer-related pain : national data
| Autor: | Michael Williams, Kate Scofield, Jess Briggs, Matthew Makin, Marlise Poolman, Nick Campkin, Barry Laird, Manohar Sharma, Catriona R Mayland |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Percutaneous medicine.medical_treatment clinical decisions Medicine (miscellaneous) 03 medical and health sciences 0302 clinical medicine Quality of life Rating scale Internal medicine medicine cancer pain 030212 general & internal medicine Mesothelioma Adverse effect Original Research Cordotomy Oncology (nursing) business.industry Cancer General Medicine medicine.disease Medical–Surgical Nursing bacteria Cancer pain business 030217 neurology & neurosurgery |
| Zdroj: | BMJ Supportive & Palliative Care |
| ISSN: | 2045-435X |
| Popis: | ObjectivesPercutaneous cervical cordotomy (PCC) is an interventional ablative procedure in the armamentarium for cancer pain treatment, but there is limited evidence to support its use. This study aimed to assess the effectiveness and safety of PCC.MethodsAnalysis was undertaken of the first national (UK) prospective data repository of adult patients with cancer undergoing PCC for pain treatment. The relationship between pain and other outcomes before and after PCC was examined using appropriate statistical methods.ResultsData on 159 patients’ PCCs (performed from 1 January 2012 to 6 June 2017 in three centres) were assessed: median (IQR) age was 66 (58–71) years, 47 (30%) were female. Mesothelioma was the most common primary malignancy (57%). The median (IQR) time from cancer diagnosis to PCC assessment was 13.3 (6.2–23.2) months; PCC to follow-up was 9 (8–25) days; and survival after PCC was 1.3 (0.6–2.8) months. The mean (SD) for ‘average pain’ using a numerical rating scale was 6 (2) before PCC and 2 (2) at follow-up, and for ‘worst pain’ 9 (1) and 3 (3), respectively. The median (IQR) reduction in strong opioid dose at follow-up was 50% (34–50). With the exception of ‘activity’, all health-related quality of life scores (5-level version of EuroQol-5 Dimension) either improved or were stable after PCC. Six patients (4%) had PCC-related adverse events.ConclusionsPCC is an effective treatment for cancer pain; however, findings in this study suggest PCC referrals tended to be late in patients’ disease trajectories. Further study into earlier treatment and seeking international consensus on PCC outcomes will further enhance opportunities to improve patient care. |
| Databáze: | OpenAIRE |
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