Abstract
Celiac plexus radiosurgery – an introduction to the method and a practical manual
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
- Collegium Medicum, Faculty of Medicine, WSB University, Dąbrowa Górnicza, Poland
- Department of Anaesthesiology and Intensive Care, Centre of Postgraduate Medical Education, Warsaw, Poland
- Third Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
- Radiotherapy Planning Department; and Department of Medical Physics, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
- Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Poland
- Department of Pain Research and Treatment, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
- Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Department of Palliative Medicine, Collegium Medicum, University of Zielona Góra, Zielona Góra, Poland
- University Clinical Hospital in Poznań, Poznań, Poland
- Institute of Oncology, Sheba Medical Centre, Ramat Gan, Israel
Introduction:
Celiac plexus radioablation (CPR) is an emerging non-invasive interventional treatment for severe pain associated with cancer-related damage to the celiac plexus. Due to its complex aetiology, such pain often responds poorly to conventional analgesics, and high doses of these medications can cause toxicity. Celiac plexus radiosurgery employs advanced radiotherapy techniques to administer a high single dose of 25 Gy to the anatomically defined celiac plexus, aiming to reduce pain intensity and enhance patients’ quality of life.
Material and methods:
The safety and efficacy of CPR have been validated in a prospective single-arm clinical trial that included 125 patients.
Results:
The positive outcomes of this trial led to the integration of CPR into pain management guidelines; however, the novel approach to radiotherapy planning might be initially challenging to grasp.
Conclusions:
In this article, we provide a brief overview of the method along with a comprehensive, Polish and English-language guide on how to perform CPR and manage patients, based on our clinical experience.
Keywords
alliative care, pancreatic cancer, radioablation, metastatic disease, non-pharmacological interventions
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