Pancreatic cancer, the 12th most common cancer worldwide, is associated with pain in approximately 75% of patients at the time of diagnosis, and as much as 90% at advanced stages. The pain radiates from the upper abdomen to the lower back, worsens with time, and is often challenging to treat; significantly affecting patients’ quality of life. The pain is thought to be caused by the tumor pressing against and infiltrating the celiac plexus nerve network that lies just behind the pancreas.
As a result, a major part of cancer care is assisting patients in managing pain associated with the disease.
A recent announcement by Sheba revealed the results of an international study examining the use of a novel celiac plexus radiosurgery treatment for pain management in advanced cancer patients. Director of the Center for Translational Radiation Oncology at Sheba, Dr. Yaacov Richard Lawrence, and his team posited that targeting the celiac plexus with radiation would reduce pain, and after a positive pilot study, began a four-year validation study involving 125 patients.
The study was presented by Dr. Lawrence at the recent 2022 American Society for Radiation Oncology (ASTRO) annual meeting in San Antonio.
“Pancreatic cancer pain can be debilitating for patients, and few options are currently available for alleviating it,” explained Dr. Lawrence. “The positive results of this study are encouraging, and we believe celiac plexus radiosurgery should become a standard treatment option for pain relief for patients with advanced stages of pancreatic cancer and other cancers invading the celiac plexus.”
Pain interference scale scores, which measure how much the pain interferes with a patient’s daily routine, improved significantly both three and six weeks after receiving a single radiation treatment. Of the 90 evaluable patients at three weeks after initial treatment, 48 (53.3%) had at least a partial pain response, with the average pain score dropping 2.5 points at three weeks and 3.2 points at six weeks. The treatment was well tolerated by study participants, whose median age was 65.5, and no severe side effects were reported.
This trial establishes celiac plexus radiosurgery as a feasible treatment option for patients with pancreatic tumors or other tumors invading the celiac axis, lessening the use of opioids and analgesics for pain treatment.