Predictors of pain response after endoscopic ultrasound-guided celiac plexus neurolysis for abdominal pain caused by pancreatic malignancy.
Predictors of pain response after endoscopic ultrasound-guided celiac plexus neurolysis for abdominal pain caused by pancreatic malignancy.
复制标题
内镜超声引导下腹腔丛神经松解术治疗胰腺恶性肿瘤引起的腹痛后疼痛反应的预测因素
DOI：
10.3748/wjg.v27.i1.69
复制
发表时间：
2021-01-07
影响因子：
4.3
通讯作者：
Ding Z
中科院分区：
文献类型：
--
作者：
Han CQ;Tang XL;Zhang Q;Nie C;Liu J;Ding Z
背景技术内窥镜超声引导的腹腔神经丛神经松解术（EUS-CPN）作为一种微创方法已经受到欢迎，并且目前广泛用于治疗胰腺癌相关的疼痛。然而，对治疗的反应是可变的。目的 确定 EUS-CPN 的疗效并探讨 EUS-CPN 对胰腺癌相关疼痛的疼痛反应的决定因素。方法 对 58 例因无法手术的胰腺癌而出现腹痛并接受 EUS-CPN 的患者进行回顾性研究。根据 EUS-CPN 后 1 周和 4 周时的视觉模拟量表疼痛评分评估疼痛缓解效果。进行单变量和多变量逻辑回归分析以探索疼痛反应的预测因素。结果 1 周和 4 周时，分别有 74.1% 和 67.2% 的患者获得良好的疼痛反应。位于胰腺体/尾部的肿瘤和接受双侧治疗的患者与良好结果的相关性较弱。多变量分析显示，患有隐形神经节和转移性疾病的患者分别是 1 周和 4 周 EUS-CPN 阴性反应的重要因素，特别是腹腔神经丛的侵犯（比值比 (OR) = 13.20，1 周 P = 0.003，4 周 OR = 15.11，P = 0.001）。没有报告严重不良事件。结论 EUS-CPN 是一种安全有效的治疗顽固性胰腺癌相关疼痛的方法。看不见的神经节、远处转移和腹腔神经丛的侵犯是 EUS-CPN 对胰腺癌相关疼痛疗效较差的预测因素。对于这些患者，疗效值得关注。
BACKGROUND Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) has gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. However, response to treatment is variable. AIM To identify the efficacy of EUS-CPN and explore determinants of pain response in EUS-CPN for pancreatic cancer-associated pain. METHODS A retrospective study of 58 patients with abdominal pain due to inoperable pancreatic cancer who underwent EUS-CPN were included. The efficacy for palliation of pain was evaluated based on the visual analog scale pain score at 1 wk and 4 wk after EUS-CPN. Univariable and multivariable logistic regression analyses were performed to explore predictors of pain response. RESULTS A good pain response was obtained in 74.1% and 67.2% of patients at 1 wk and 4 wk, respectively. Tumors located in the body/tail of the pancreas and patients receiving bilateral treatment were weakly associated with a good outcome. Multivariate analysis revealed patients with invisible ganglia and metastatic disease were significant factors for a negative response to EUS-CPN at 1 wk and 4 wk, respectively, particularly for invasion of the celiac plexus (odds ratio (OR) = 13.20, P = 0.003 for 1 wk and OR = 15.11, P = 0.001 for 4 wk). No severe adverse events were reported. CONCLUSION EUS-CPN is a safe and effective form of treatment for intractable pancreatic cancer-associated pain. Invisible ganglia, distant metastasis, and invasion of the celiac plexus were predictors of less effective response in EUS-CPN for pancreatic cancer-related pain. For these patients, efficacy warrants attention.
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DOI：
10.1155/2013/327036
发表时间：
2013
期刊：
Diagnostic and therapeutic endoscopy
影响因子：
--
作者：
Leblanc JK;Rawl S;Juan M;Johnson C;Kroenke K;McHenry L;Sherman S;McGreevy K;Al-Haddad M;Dewitt J
通讯作者：
Dewitt J
影响因子：
5.2
作者：
Minaga K;Takenaka M;Kamata K;Yoshikawa T;Nakai A;Omoto S;Miyata T;Yamao K;Imai H;Sakamoto H;Kitano M;Kudo M
通讯作者：
Kudo M
影响因子：
5.7
作者：
EISENBERG, E;CARR, DB;CHALMERS, TC
通讯作者：
CHALMERS, TC
影响因子：
9.8
作者：
Sahai, Anand V.;Lemelin, Valery;Paquin, Sarto C.
通讯作者：
Paquin, Sarto C.
DOI：
10.6004/jnccn.2017.0131
发表时间：
2017-08-01
影响因子：
13.4
作者：
Tempero, Margaret A.;Malafa, Mokenge P.;Darlow, Susan
通讯作者：
Darlow, Susan