Double Anterior Stereotactic Cingulotomy for Intractable Oncological Pain
Ido Strauss1, Assaf Berger, Shlomit Ben Moshe
1Department of Neurosurgery, Division of Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel.
Stereotactic and Functional Neurosurgery
|January 10, 2018
Summary
Stereotactic anterior cingulotomy effectively reduced refractory oncological pain in advanced cancer patients. This procedure demonstrated significant pain relief and improved quality of life, with manageable side effects.
Area of Science:
- Neurosurgery
- Pain Management
- Oncology
Background:
- Stereotactic anterior cingulotomy is used for refractory oncological pain.
- Optimal targets, patient selection, and outcome measures require definition.
Purpose of the Study:
- Evaluate the safety and efficacy of ablating two cingulotomy targets per side.
- Assess pain relief using the Brief Pain Inventory (BPI) and Visual Analogue Scale (VAS).
Main Methods:
- Retrospective review of 13 patients with advanced metastatic cancer and intractable pain.
- Underwent 14 stereotactic anterior cingulotomy procedures between November 2015 and February 2017.
Main Results:
- Significant reduction in VAS pain scores (9 to 4, p=0.003) and BPI severity/interference scores (p=0.028, p=0.043).
- 82% and 71% reported substantial pain relief at 1 and 3 months, respectively.
- Transient confusion/apathy in 38% of patients; stable cognitive functions observed.
Conclusions:
- Double stereotactic cingulotomy is a safe and effective option for refractory oncological pain.
- The procedure offers significant pain alleviation and functional improvement in selected patients.
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