Alleviating retroperitoneal pain with celiac plexus radiosurgery
Mené sur 125 patients atteints d'un cancer de stade avancé (pancréas ou autre tumeur localisée au niveau du tronc coeliaque ; âge médian : 65,5 ans), cet essai multicentrique de phase II évalue l'intérêt d'une radiochirurgie du plexus coeliaque pour soulager la douleur
The celiac plexus is a network of nerves surrounding the celiac artery that transmits pain signals from the upper abdominal organs. Abdominal malignancies, notably pancreatic cancer, often cause debilitating pain by disrupting local anatomy and infiltrating the celiac plexus. Initial pain management involve opioids and adjunct medications, but as pain becomes refractory, additional strategies are required. Although celiac plexus neurolysis is commonly employed, randomised controlled trials comparing it with pharmacotherapy have yielded conflicting results. Even when effective, relief from celiac plexus neurolysis can be temporary, as pain can recur within 8–12 weeks.
The Lancet Oncology 2023