Intrathecal drug delivery systems for cancer pain: A retrospective analysis at a single tertiary medical center in China

Abstract

Objective: Intrathecal drug delivery systems (IDDS) have been clinically applied to treat refractory cancer-related pain for years. In this study, we demonstrate the current clinical practice and outcomes of IDDS for cancer pain management over a 3-year period at a single tertiary medical center in China. Methods: Patients who received IDDS implantation for cancer-related pain from 2021 to 2023 were identified. The electronic medical records of all eligible patients were retrospectively reviewed for study data including baseline characteristics, IDDS variables and postoperative clinical outcomes. Results: A total of 96 consecutive individuals were identified for analysis and complete follow-up information was available in 72 patients with a follow-up rate of 75 %. Patients were 49.0 % female with a mean age of 62 ± 10 years. The top five cancer types in IDDS population were lung (34.4 %), colorectal (17.7 %), pancreatic (11.5 %), breast (5.2 %) and liver (4.2 %) cancer. The median duration from cancer diagnosis to IDDS implantation was 24 months (interquartile range [IQR] 12–48 months) and from pain onset to IDDS implantation was 6 months (IQR 2–12 months). In addition, the median oral morphine equivalents (OME) daily dose was 290 mg (IQR 100–632 mg). Mean NRS was 7.5 ± 0.8 before implantation and decreased to an average of 3.0 ± 1.1 after IDDS (p < 0.001). Median overall survival after IDDS implantation was 3 months (IQR 2–6 months). Overall, 75 % family members of cancer patients were satisfied with IDDS in relieving cancer pain. Conclusion: IDDS therapy is a valuable option for patients suffering from cancer pain. More and more cancer pain patients receive IDDS to treat pain during the 3-year study period.

Keywords

• Cancer pain
• Intrathecal drug delivery systems
• Analgesia
• Intrathecal pump
• Pain management
• Retrospective study