Endoscopic Ultrasound Guided Coeliac Plexus Neurolysis for Cancer Pain
Status:
Not yet recruiting
Trial end date:
2025-03-31
Target enrollment:
Participant gender:
Summary
Many cancer patients suffer from intractable pain and which is often suboptimally controlled
by even strong opioid analgesics. Coeliac plexus neurolysis (CPN) is procedure which intended
to permanently destroy the nociceptive pathway that transmits the pain caused by the tumour.
It can be with different approaches, such as percutaneously guided by fluoroscopy,
echo-endoscopically or surgically with endoscopic approach being the more popular one in many
centers equipped with echo-endoscopic services. The effect of CPN has been well established
by some retrospective series. The overall response rate to CPN ranges from 70-90%, however,
the analgesic effect is limited and up to roughly around 3 months. It is believed that the
short-lasting analgesic effect is related to incomplete neurolysis by absolute alcohol
injection.
Recently, radiofrequency ablation (RFA) of coeliac plexus has been introduced as another mode
of CPN. So far, only one small single center randomized controlled trial (RCT) suggesting
superior performance in favour to CPN using RFA. This result has to be validated and by a RCT
with larger sample size. In addition, data concerning the quality of life (QOL) improvement
and cost-effectiveness need to be further elucidated. Therefore, the aim of this study is to
perform a RCT to look into these issues.