TY - JOUR
T1 - Efficacy of Superior Hypogastric Plexus Neurolysis for the Treatment of Cancer-Related Pelvic Pain
AU - Hou, Saiyun
AU - Novy, Diane
AU - Felice, Francis
AU - Koyyalagunta, Dhanalakshmi
N1 - Publisher Copyright:
© 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Objective: Cancer-related abdominal and pelvic pain syndromes can be debilitating and difficult to treat. The objective of this study was to evaluate the efficacy of superior hypogastric plexus blockade or neurolysis (SHPN) for the treatment of cancer-related pelvic pain. Design: Retrospective study. Setting: MD Anderson Cancer Center, Houston, Texas. Methods: We enrolled 46 patients with cancer-related pelvic pain who underwent SHPN. A numeric rating scale (NRS) was used for pain intensity, and symptom burden was evaluated using the Edmonton Symptom Assessment System at baseline, visit 1 (within one month), and visit 2 (within one to six months). Results: Forty-six patients who received SHPN showed a significant reduction in pain score from 6.9 to 5.6 at visit 1 (P = 0.01). Thirty of the 46 patients continued to complete visit 2 follow-up, and the NRS score was consistently lower at 4.5 at visit 2 (P < 0.0001), with anxiety and appetite improved significantly. There was no significant change in the morphine equivalent dose at visits 1 and 2. The efficacy of the block was not influenced by patients' age, gender, type of cancer, cancer stage, regimen of chemotherapy and/or radiation therapy, diagnostic block, approach or laterality of procedure, or type or amount of neurolytic agent. Nonsmokers with high baseline pain scores were more likely to have improved treatment outcomes from SHPN at short-Term follow-up. Adverse effects with SHPN were mild and well tolerated. Conclusions: SHPN was an effective and relatively safe procedure for pain associated with pelvic malignancies. There is a need for larger prospective trials.
AB - Objective: Cancer-related abdominal and pelvic pain syndromes can be debilitating and difficult to treat. The objective of this study was to evaluate the efficacy of superior hypogastric plexus blockade or neurolysis (SHPN) for the treatment of cancer-related pelvic pain. Design: Retrospective study. Setting: MD Anderson Cancer Center, Houston, Texas. Methods: We enrolled 46 patients with cancer-related pelvic pain who underwent SHPN. A numeric rating scale (NRS) was used for pain intensity, and symptom burden was evaluated using the Edmonton Symptom Assessment System at baseline, visit 1 (within one month), and visit 2 (within one to six months). Results: Forty-six patients who received SHPN showed a significant reduction in pain score from 6.9 to 5.6 at visit 1 (P = 0.01). Thirty of the 46 patients continued to complete visit 2 follow-up, and the NRS score was consistently lower at 4.5 at visit 2 (P < 0.0001), with anxiety and appetite improved significantly. There was no significant change in the morphine equivalent dose at visits 1 and 2. The efficacy of the block was not influenced by patients' age, gender, type of cancer, cancer stage, regimen of chemotherapy and/or radiation therapy, diagnostic block, approach or laterality of procedure, or type or amount of neurolytic agent. Nonsmokers with high baseline pain scores were more likely to have improved treatment outcomes from SHPN at short-Term follow-up. Adverse effects with SHPN were mild and well tolerated. Conclusions: SHPN was an effective and relatively safe procedure for pain associated with pelvic malignancies. There is a need for larger prospective trials.
KW - Cancer
KW - Cancer Pain
KW - Nerve Block
KW - Neurolysis
KW - Pelvic Pain
KW - Superior Hypogastric Plexus
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U2 - 10.1093/pm/pnz151
DO - 10.1093/pm/pnz151
M3 - Article
C2 - 31343689
AN - SCOPUS:85075117964
SN - 1526-2375
VL - 21
SP - 1255
EP - 1262
JO - Pain Medicine (United States)
JF - Pain Medicine (United States)
IS - 6
ER -