Clinical analysis of ultrasound-guided celiac ganglion irradiation with 125I seeds for pain control in local advanced pancreatic carcinoma

Abstract

Objective To evaluate the safety and efficacy of direct celiac ganglion irradiation with 125I seeds for pain management of unresectable and local recurrent pancreatic cancer. Methods This study enrolled 25 consecutive patients within 15 unresectable pancreatic head cancer patients and 10 local recurrent patients, who had moderate to severe pain resulting from biopsy- proven advanced pancreatic cancer. All patients underwent US-guided direct celiac ganglion irradiation with 125I seeds. Follow-up was conducted at least once weekly until death. Visual Analog Scale (VAS) score, mean analgesic consumption, quality of life (QoL) and procedure-related complications were evaluated during follow-up. Results All patients successfully underwent implantation at one attempt. The mean number of seeds implanted in the celiac ganglion per patient was 4 (range 2-8). Two weeks later, the VAS score and mean analgesic consumption were significantly less than preoperative value. The overall quality of life of patients in one and three months after operation was significantly improved compared with that before treatment. No procedure-related deaths or major complications occurred. Only one suffers from gastric retention, Two suffer from diarrhea, and one suffers from standing syncope, All of them recovered by adjunctive therapy. Conclusions US-guided direct celiac ganglion irradiation with 125I seeds is safe and effective for alleviating refractory cancer pain due to unresectable and local recurrent pancreatic cancer. Key words: Ultrasonography; Iodine radioisotopes; Brachytherapy; Pancreatic cancer; Pain