Strategies for interventional therapies in cancer-related paina crossroad in cancer pain management

被引:14
作者
Allano, Gilles [1 ]
George, Brigitte [2 ]
Minello, Christian [3 ]
Burnod, Alexis [4 ]
Maindet, Caroline [5 ]
Lemaire, Antoine [6 ]
机构
[1] Mutualist Clin Porte de Lorient, Pain Management Unit, Lorient, France
[2] Hosp St Louis, Pain Management Unit, Paris, France
[3] Canc Ctr Georges Francois Leclerc, Anesthesia Intens Care Dept, Dijon, France
[4] PSL Res Univ, Inst Curie, Dept Support Care, Paris, France
[5] Grenoble Alpes Univ Hosp, Pain Management Ctr, Grenoble, France
[6] Valenciennes Gen Hosp, Oncol & Med Specialties Dept, Valenciennes, France
关键词
Pain management; Personalized management; Multimorphic pain; Cancer pain; Neuraxial analgesia; Nerve block; INTRATHECAL DRUG-DELIVERY; CONFERENCE PACC RECOMMENDATIONS; SPINAL-CORD STIMULATION; DORSAL-ROOT GANGLION; QUALITY-OF-LIFE; GUIDED RADIOFREQUENCY ABLATION; METASTASES INVOLVING BONE; CELIAC PLEXUS BLOCK; PERCUTANEOUS VERTEBROPLASTY; SURGICAL-MANAGEMENT;
D O I
10.1007/s00520-019-04827-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PurposeInterventional therapies are important to consider when facing cancer pain refractory to conventional therapies. The objective of the current review is to introduce these effective strategies into dynamic interdisciplinary pain management, leading to an exhaustive approach to supportive oncology.MethodsCritical reflection based on literature analysis and clinical practice.ResultsInterventional therapies act on the nervous system via neuromodulation or surgical approaches, or on primitive or metastatic lesions via interventional radiotherapy, percutaneous ablation, or surgery. Interventional therapies such as neuromodulations are constantly evolving with new technical works still in development. Nowadays, their usage is better defined, depending on clinical situations, and their impact on quality of life is proven. Nevertheless their availability and acceptability still need to be improved. To start with, a patient's interdisciplinary evaluation should cover a wide range of items such as patient's performance and psychological status, ethical considerations, and physiochemical and pharmacological properties of the cerebrospinal fluid for intrathecal neuromodulation. This will help to define the most appropriate strategy. In addition to determining the pros and cons of highly specialized interventional therapies, their relevance should be debated within interdisciplinary teams in order to select the best strategy for the right patient, at the right time.ConclusionsUltimately, the use of the interventional therapies can be limited by the requirement of specific trained healthcare teams and technical support, or the lack of health policies. However, these interventional strategies need to be proposed as soon as possible to each patient requiring them, as they can greatly improve quality of life.
引用
收藏
页码:3133 / 3145
页数:13
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