[NEUROSURGICAL INTERVENTIONS FOR INTRACTABLE ONCOLOGICAL PAIN]

Area of Science:

• Neurosurgery
• Oncology
• Pain Management

Background:

• Cancer pain is a prevalent and debilitating symptom, significantly impacting patient quality of life.
• Pharmacotherapy, primarily with opioids, is the standard for cancer pain management.
• Refractory cancer pain, unresponsive to or poorly tolerated by medication, affects a subset of patients.

Purpose of the Study:

• To review neurosurgical interventions for refractory cancer pain.
• To highlight the importance of interdisciplinary patient selection for successful outcomes.
• To present clinical cases illustrating the application of specific neurosurgical techniques.

Main Methods:

• Review of neurosurgical procedures including percutaneous cordotomy, punctuate midline myelotomy, and stereotactic cingulotomy.
• Emphasis on patient selection by a multidisciplinary team (palliative care, pain specialists, neurosurgeon).
• Presentation of representative clinical cases to guide therapeutic approach decisions.

Main Results:

• Percutaneous cordotomy is effective for unilateral pain.
• Punctuate midline myelotomy addresses visceral pain.
• Stereotactic cingulotomy is indicated for diffuse pain syndromes.
• Careful patient selection is crucial for the success of these neurosurgical interventions.

Conclusions:

• Neurosurgical interventions provide valuable options for managing refractory cancer pain.
• An interdisciplinary approach to patient selection optimizes the efficacy and safety of these procedures.
• These techniques can significantly improve functional status and quality of life for select cancer patients.