Evaluation of intrathecal drug delivery system for intractable pain in advanced malignancies: A prospective cohort study.

Abstract:

:Pain is prevalent in advanced malignancies; however, some patients cannot get adequate pain relief by conservative routes of analgesic administration or experience serious side effects related to high dose of opioids. For those who have exhausted multimodal conservative analgesic, intrathecal drug delivery is an alternative intervention for truly effective pain management. The objective of this study was to evaluate the clinical efficacy and safety of intrathecal drug delivery system (IDDS) for the treatment of intractable pain in advanced cancer patients.A prospective cohort study was performed between July 2015 and October 2016. Fifty-three patients undergoing intractable cancer-related pain or intolerable drug-related adverse effects were recruited and received IDDS therapy with a patient-controlled intrathecal analgesia pump. The assessment was conducted during admission, in titration period, and followed up monthly to death by scheduled refill visits. Pain numeric rating scale scores, comprehensive toxicity scores, quality of life scores, systemic opioid use (basal and breakthrough dose), intrathecal morphine use (basal and patient-controlled intrathecal analgesia dose), and complications were recorded to evaluate the curative effect and safety.Between baseline and all subsequent follow-ups, statistically significant decreases in pain numeric rating scale scores and comprehensive toxicity scores were verified. A statistical improvement in quality of life scores was found after starting IDDS therapy. Both basal and breakthrough doses of systemic opioid showed a significant decrease during the follow-up period. And there was a modest escalation in the intrathecal morphine dose throughout the duration of study. No infective, device-related, and catheter-related complications were observed.The findings showed that IDDS therapy allowed for rapid and highly effective pain relief with less toxicity in comparison to conservative medications. Patients with advanced malignancies would also benefit from an improvement in the life quality after the procedure. IDDS therapy represented a valuable option for intractable cancer-related pain management.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Zheng S,He L,Yang X,Li X,Yang Z

doi

10.1097/MD.0000000000006354

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

e6354

issue

11

eissn

0025-7974

issn

1536-5964

pii

00005792-201703170-00051

journal_volume

96

pub_type

杂志文章

相关文献

MEDICINE文献大全
  • Community-acquired pneumonia. A prospective outpatient study.

    abstract::We initiated a prospective study with a group of practitioners to assess the etiology, clinical presentation, and outcome of community-acquired pneumonia in patients diagnosed in the outpatient setting. All patients with signs and symptoms suggestive of pneumonia and an infiltrate on chest X-ray underwent an extensive...

    journal_title:Medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00005792-200103000-00001

    authors: Bochud PY,Moser F,Erard P,Verdon F,Studer JP,Villard G,Cosendai A,Cotting M,Heim F,Tissot J,Strub Y,Pazeller M,Saghafi L,Wenger A,Germann D,Matter L,Bille J,Pfister L,Francioli P

    更新日期:2001-03-01 00:00:00

  • Comparative Effectiveness of Biologic Therapy Regimens for Ankylosing Spondylitis: A Systematic Review and a Network Meta-Analysis.

    abstract::To establish the comparative effectiveness of all available biologic therapy regimens for ankylosing spondylitis, we performed a systematic review and a Bayesian network meta-analysis of randomized controlled trials. PubMed, Medline, Embase, Cochrane library, and ClinicalTrials.gov were searched from the inception of ...

    journal_title:Medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/MD.0000000000003060

    authors: Chen C,Zhang X,Xiao L,Zhang X,Ma X

    更新日期:2016-03-01 00:00:00

  • Correlation of fatigue with other disease related and psychosocial factors in patients with rheumatoid arthritis treated with tocilizumab: ACT-AXIS study.

    abstract::To assess the hypothesis if tocilizumab (TCZ) is effective on disease activity, and also its effect in fatigue and other clinical and psychological disease-related factors in patients with rheumatoid arthritis (RA) treated with TCZ.A 24-week, multicenter, prospective, observational study in patients with moderate to s...

    journal_title:Medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/MD.0000000000015947

    authors: Corominas H,Alegre C,Narváez J,Fernández-Cid CM,Torrente-Segarra V,Gómez MR,Pan FM,Morlà RM,Martínez FJR,Gómez-Centeno A,Ares LL,Molina RG,González-Albo SP,Dalmau-Carolà J,Pérez-García C,Álvarez CB,Ercole L,Terrancle MÁ

    更新日期:2019-06-01 00:00:00

  • Pituitary resistance to thyroid hormone caused by a novel mutation (H435A) in the thyroid hormone receptor beta: A case report.

    abstract:RATIONALE:In patients with pituitary thyroid hormone resistance, the ability of the pituitary gland to detect (and down-regulate) the increase of triiodothyronine is selectively impaired, while the periphery remains sensitive to triiodothyronine levels, producing symptoms of peripheral thyrotoxicity. Subsequently, ther...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000010544

    authors: Yu C,Zhao J,Yao J,Wang H,Shang H,Zhang R,Cui Y,Wang L,Dong J,Liao L

    更新日期:2018-05-01 00:00:00

  • Successful treatment of colorectal liver metastasis harboring intrahepatic cholangiocarcinoma: A case report.

    abstract:RATIONALE:Colorectal liver metastasis develops in 50% of patients diagnosed with colorectal cancer, whereas concurrent intrahepatic cholangiocarcinoma (ICC) and colorectal liver metastases is extremely rare. PATIENT CONCERNS:A 72-year-old man was referred to our hospital complaining of abdominal discomfort, diarrhea, ...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000013751

    authors: Cheng X,Zhao F,Chen D,Yang P,Zhong W,Xu X,Wang W

    更新日期:2018-12-01 00:00:00

  • New Deep Dermal ADM Incorporates Well in Case Series of Complex Breast Reconstruction Patients.

    abstract::Breast cancer patients with significant comorbidities present reconstructive challenges due to a predictably high complication rate. During expander-based breast reconstruction, human acellular dermal matrix (ADM) is often used to prevent pectoralis muscle retraction, facilitate early expansion, and improve cosmetic o...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000000745

    authors: Wilson HB

    更新日期:2015-05-01 00:00:00

  • Integrative network analysis identifies an immune-based prognostic signature as the determinant for the mesenchymal subtype in epithelial ovarian cancer.

    abstract:BACKGROUND:Epithelial ovarian cancer (EOC) has been classified into four molecular subtypes, of which the mesenchymal subtype has the poorest survival. Our goal is to develop an immune-based prognostic signature by incorporating molecular subtypes for EOC patients. METHODS:The gene expression profiles of EOC samples w...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000022549

    authors: Sheng M,Tong H,Lu X,Shanshan N,Zhang X,Reddy BA,Shu P

    更新日期:2020-10-09 00:00:00

  • Histogram Analysis of Apparent Diffusion Coefficient in Differentiating Pancreatic Adenocarcinoma and Neuroendocrine Tumor.

    abstract::The aim of this study was to investigate whether histogram analysis in diffusion-weighted (DW) magnetic resonance imaging (MRI) can help differentiate pancreatic adenocarcinomas from neuroendocrine tumors.Sixty-four patients with histologically confirmed 53 pancreatic adenocarcinomas or 19 neuroendocrine tumors underw...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000002574

    authors: Shindo T,Fukukura Y,Umanodan T,Takumi K,Hakamada H,Nakajo M,Umanodan A,Ideue J,Kamimura K,Yoshiura T

    更新日期:2016-01-01 00:00:00

  • Genetic variations associated with telomere length affect the risk of gastric carcinoma.

    abstract::This study aimed to further understand the role of relative telomere length (RTL) in susceptibility to gastric carcinoma (GC) and investigate the association between genetic polymorphisms in the telomere length related genes and GC risk.RTL was measured using the real-time quantitative polymerase chain reaction from 1...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000020551

    authors: Lili M,Yuxiang F,Zhongcheng H,Ying S,Ru C,Rong X,Jiang L

    更新日期:2020-06-05 00:00:00

  • Protein-losing enteropathy secondary to nonocclusive mesenteric ischemia: A case report.

    abstract:RATIONALE:Nonocclusive mesenteric ischemia (NOMI) is a life-threatening disorder; prompt diagnosis is vital. Surgical treatment is often required, but some cases can be treated conservatively. We herein report an extremely rare case wherein protein-losing enteropathy (PLE) developed after conservative treatment of NOMI...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000013403

    authors: Shima T,Ozeki M,Kinoshita T,Honda K,Inoue H,Morita S

    更新日期:2018-11-01 00:00:00

  • Primary anorectal malignant melanoma: A case report.

    abstract:INTRODUCTION:Anorectal malignant melanoma (AMM) is a rare and aggressive malignance with poor prognosis, yet no consensus of treatment exists to date. Abdominoperineal resection surgery (APR) is the standard treatment of anorectal malignant melanoma, capable of controlling lymphatic spread and obtaining a large negativ...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000019028

    authors: Xu X,Ge T,Wang G

    更新日期:2020-01-01 00:00:00

  • The association between rs12885713 polymorphism in CALM1 and risk of osteoarthritis: A meta-analysis of case-control studies.

    abstract:OBJECTIVE:The single nucleotide polymorphism (SNP) rs12885713 of calmodulin 1 gene (CALM1) has been reported to involve in the etiology of osteoarthritis (OA) in several association studies with limited sample size and conflicting results. The purpose of the present systematic review and meta-analysis was to evaluate a...

    journal_title:Medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/MD.0000000000012235

    authors: Shi J,Gao ST,Lv ZT,Sheng WB,Kang H

    更新日期:2018-09-01 00:00:00

  • Clinical and radiological outcomes of hemivertebra resection for congenital scoliosis in children under age 10 years: More than 5-year follow-up.

    abstract::The surgical treatment of congenital scoliosis under 10 years is difficult as it involves resecting vertebrae. Moreover, patient follow-up after surgery is extremely important because the patient is a child whose growth has not been completed. However, there are very few long-term follow-up studies after surgical trea...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000021720

    authors: Yang JH,Chang DG,Suh SW,Kim W,Park J

    更新日期:2020-08-07 00:00:00

  • Molecular profiling of the colon cancer in South-Eastern Romania: Results from the MERCUR study.

    abstract:ABSTRACT:Colorectal cancer is a heterogeneous disease with multiple epigenetic alterations and different molecular features. The molecular classification is based on 2 major distinct pathways: microsatellite stable pathway and the microsatellite instability pathway. Molecular profiling of colorectal cancer provides imp...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000024062

    authors: Popescu RC,Tocia C,Brînzan C,Cozaru GC,Deacu M,Dumitru A,Leopa N,Mitroi AF,Nicolau A,Dumitru E

    更新日期:2021-01-08 00:00:00

  • A special superior cortex compressive fracture of femoral neck: Two case reports.

    abstract:RATIONALE:Garden type I femoral neck fractures are incomplete stable fractures with impaction in valgus fractures that the question of whether there exists Garden type I femoral neck fracture is currently uncertain. There is still disagreement on the existence of the Garden type I fractures. PATIENT CONCERNS:Herein we...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000012876

    authors: Xian H,Zhang H,Lian K,Lin D

    更新日期:2018-10-01 00:00:00

  • Comparison of the long-term efficacy of tenofovir and entecavir in nucleos(t)ide analogue-naïve HBeAg-positive patients with chronic hepatitis B: A large, multicentre, randomized controlled trials.

    abstract:OBJECTIVE:We conducted this study to compare the efficacy and safety of entecavir and tenofovir in the treatment of treatment-naïve HBV e antigen (HBeAg)-positive patients with chronic hepatitis B (CHB) for 144 weeks. METHODS:A total of 320 treatment-naïve HBeAg-positive CHB patients who received randomly a single reg...

    journal_title:Medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/MD.0000000000013983

    authors: Cai D,Pan C,Yu W,Dang S,Li J,Wu S,Jiang N,Wang M,Zhang Z,Lin F,Xin S,Yang Y,Shen B,Ren H

    更新日期:2019-01-01 00:00:00

  • Clinical effects of extracorporeal shock-wave therapy and ultrasound-guided local corticosteroid injections for plantar fasciitis in adults: A meta-analysis of randomized controlled trials.

    abstract:BACKGROUND:The argument on whether extracorporeal shock-wave therapy (ESWT) and corticosteroid injections (CSIs) exert an equivalent pain control or which is the better treatment for plantar fasciitis (PF) in adults remains to be resolved. It is important and necessary to conduct a meta-analysis to make a relatively mo...

    journal_title:Medicine

    pub_type: 杂志文章,meta分析

    doi:10.1097/MD.0000000000013687

    authors: Li S,Wang K,Sun H,Luo X,Wang P,Fang S,Chen H,Sun X

    更新日期:2018-12-01 00:00:00

  • Prognostic Effects of Adjuvant Chemotherapy-Induced Amenorrhea and Subsequent Resumption of Menstruation for Premenopausal Breast Cancer Patients.

    abstract::Chemotherapy-induced amenorrhea (CIA) is a side effect that occurs in patients with breast cancer (BC) as a result of chemotherapy. These patients require special treatments to avoid infertility and menopause. However, the factors controlling CIA, resumption of menstruation (RM), and persistence of menstruation after ...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000003301

    authors: Jeon SJ,Lee JI,Jeon MJ,Lee M

    更新日期:2016-04-01 00:00:00

  • Renal transplantation in scleroderma.

    abstract::Although the outcome of renal transplantation in patients with systemic lupus erythematosus (SLE) has been studied, there are few reports about the outcome of patients with systemic sclerosis who have undergone renal transplantation. We retrospectively collected data from the United Network for Organ Sharing (UNOS) Sc...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/00005792-199911000-00003

    authors: Chang YJ,Spiera H

    更新日期:1999-11-01 00:00:00

  • Efficacy and safety of Xiyanping for COVID-2019: A protocol for systematic review and meta-analysis.

    abstract:BACKGROUND:Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the severe acute respiratory syndrome coronavirus-2.COVID-19 is highly pathogenic and infectious. COVID-19 epidemic is still spreading all over the world, and there is no sign of stopping at present. There is no specific cure for this disease...

    journal_title:Medicine

    pub_type: 杂志文章,meta分析

    doi:10.1097/MD.0000000000022962

    authors: Zhou H,Chen D,Zhang Y,Zhu Q,Yang Y,Liu Y,Gong G,Xie C

    更新日期:2020-11-13 00:00:00

  • Does Breast Magnetic Resonance Imaging Combined With Conventional Imaging Modalities Decrease the Rates of Surgical Margin Involvement and Reoperation?: A Case-Control Comparative Analysis.

    abstract::The objective of this study was to assess whether preoperative breast magnetic resonance imaging (MRI) combined with conventional breast imaging techniques decreases the rates of margin involvement and reexcision.Data on patients who underwent surgery for primary operable breast cancer were obtained from the Changhua ...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000003810

    authors: Lai HW,Chen CJ,Lin YJ,Chen SL,Wu HK,Wu YT,Kuo SJ,Chen ST,Chen DR

    更新日期:2016-05-01 00:00:00

  • Not only for melanoma. Subcutaneous pseudoprogression in lung squamous-cell carcinoma treated with nivolumab: A case report.

    abstract:RATIONALE:Pseudoprogression, that is, initial tumor growth followed by subsequent tumor regression, has been well described for immunomodulation therapy in melanoma patients. This phenomenon is not well defined in lung cancer. Nivolumab, an anti-PD-1 monoclonal antibody, was recently approved for nonsmall cell lung can...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000005951

    authors: Sarfaty M,Moore A,Dudnik E,Peled N

    更新日期:2017-01-01 00:00:00

  • Plasma cells and lymphoid aggregates in sleeve gastrectomy specimens: Normal or gastritis?

    abstract::Lymphoid follicles/aggregates in gastric biopsies have been traditionally linked to Helicobacter pylori gastritis, and less commonly to other inflammatory and neoplastic conditions. The frequency of such aggregates in normal stomachs has yet to be adequately evaluated. This is especially relevant when it comes to diag...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000018926

    authors: Chakhachiro Z,Saroufim M,Safadi B,Attieh M,Assaf N,Shamseddine G,Tamim H,Boulos F

    更新日期:2020-02-01 00:00:00

  • Primary diffuse large B-cell lymphoma as a chest-wall mass: A case report.

    abstract:RATIONALE:Primary diffuse large B-cell lymphoma of the chest wall is extremely rare. A majority of the pleural lymphomas develop in patients with chronic tuberculous pyothorax. The underlying mechanism might be attributed to the sustained stimulation of chronic inflammation. Surgery followed by adjuvant chemotherapy ca...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000013291

    authors: Zhang Q,Ju Y,Qu T,Wang T,Liu X

    更新日期:2018-11-01 00:00:00

  • Repair of a defect in the cervical trachea with thyroid-pericardium flap: A case report.

    abstract:RATIONALE:Primary end-to-end anastomosis is common in adult trachea resection. Nevertheless, considering that the utilization of grafts is still essential for restoring defect in long-segment tracheal resection surgery, long-segment tracheal resection and reconstruction still remain challenging. Herein we present a nov...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000017871

    authors: Xie H,Zhang Y,Yu F,Wang X

    更新日期:2019-11-01 00:00:00

  • Step Counter Use and Sedentary Time in Adults: A Meta-Analysis.

    abstract::Although step counters are increasingly being used in walking programmes to promote sedentary behavior changes in adults, their effectiveness remains unknown. The aim of this meta-analysis of randomized controlled trials (RCTs) was to assess the effectiveness of step counter use in reducing sedentary time among adults...

    journal_title:Medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/MD.0000000000001412

    authors: Qiu S,Cai X,Ju C,Sun Z,Yin H,Zügel M,Otto S,Steinacker JM,Schumann U

    更新日期:2015-09-01 00:00:00

  • A five year CT surveillance of ciliated retroperitoneal foregut cyst resembling a cystic pancreatic lesion: A case report.

    abstract:INTRODUCTION:Ciliated retroperitoneal foregut cysts are rare, and to obtain a preoperative definitive diagnosis of this condition is relatively difficult. In addition, the exact mechanism and formation of ciliated retroperitoneal foregut cysts remains unknown. CASE PRESENTATION:Here, we report a case of a 47-year-old ...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000010783

    authors: Chen HY,Wei SM,Chen JY,Zhu XL,Yu RS

    更新日期:2018-05-01 00:00:00

  • Jingui Shenqi pill for nocturia due to nocturnal polyuria: A protocol for systematic review and meta-analysis.

    abstract:BACKGROUND:The incidence of nocturia is high and will seriously affect patients' physical and mental health. Nocturnal polyuria is the most critical cause of nocturia, There are few drugs currently used to treat nocturia due to Nocturnal Polyuria (NP). The guide highly recommends only Desmopressin. There is an urgent n...

    journal_title:Medicine

    pub_type: 杂志文章,meta分析

    doi:10.1097/MD.0000000000023742

    authors: Fan Z,Wang Z,Deng J,Jiang Y

    更新日期:2020-12-18 00:00:00

  • Protocol for a systematic review and meta-analysis of the efficacy of acupuncture and electroacupuncture against chemotherapy-induced peripheral neuropathy.

    abstract:INTRODUCTION:Chemotherapy-induced peripheral neuropathy (CIPN) occurs in approximately 30% to 40% of patients who receive chemotherapy; however, standardized treatment for CIPN has not yet been developed. Acupuncture is widely used to treat CIPN in Korea, but its efficacy has not been investigated. The purpose of this ...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000015098

    authors: Hwang MS,Lee HY,Lee JH,Choi TY,Lee JH,Ko YS,Choi SY,Park TY

    更新日期:2019-04-01 00:00:00

  • Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult: A case report and a review of the literature.

    abstract:RATIONALE:Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by rapidly progressive hypertension, headache, and disturbance of consciousness. Moreover, RPLS is rarely reported after apatinib treatment. PATIENT CONCERNS:We present a case of RPLS induced by apatinib in this report. The patient had...

    journal_title:Medicine

    pub_type: 杂志文章

    doi:10.1097/MD.0000000000017787

    authors: Lv Y,Zhang Y,Zhang J,Liang N,Liu F,Liu R

    更新日期:2019-11-01 00:00:00