Novel approach delivers quality-of-life benefits for patients with pancreatic cancer

Celiac plexus radiosurgery reduced pain and the use of opioids in patients with pancreatic cancer or other tumours that involved the celiac axis. Furthermore, the health-related quality-of-life (HR-QoL) of patients appeared to be improved following this therapy. These were the main results of an international phase 2 study investigating a novel therapy that aimed to target pancreatic pain.

“At Sheba Medical Center, we developed a novel technique to target pain from pancreatic cancer, involving the administration of a very high dose of radiation, not to the tumour but to the celiac plexus (25 Gy * 1),” explained Dr Yaacov Lawrence (Sheba Medical Center, Israel). A pilot trial delivered encouraging response rates for this approach [1], instigating the current, international, phase 2 study. Dr Lawrence and co-investigators included 149 patients with retroperitoneal pain from pancreatic cancer or any other cancer involving the celiac blood vessels [2]. A previous publication reported that the primary endpoint, change in Brief Pain Inventory ‘average pain’, was met [3]. Dr Lawrence presented the HR-QoL results of the study.

The Functional Assessment of Cancer Therapy – General (FACT-G) was significantly improved from baseline to 3 and 6 weeks after therapy (mean score 57 vs 63 vs 67; P<0.05). A similar result was observed for the FACT-Hep questionnaire (mean score 96 vs 107 vs 113; P<0.05), the hepatobiliary cancer subscale (P<0.05), and the FACT-Hep trial outcome index (P<0.05). Data from FACT-G subscales demonstrated that improvements were made on the physical well-being subscale (P<0.05) and the emotional well-being subscale (P<0.05) but not on the social/family and functional well-being subscales.

These results warrant further investigation of this promising approach for the pancreatic cancer population, with a treatment showing improved HR-QoL.

1. Hammer L, et al. Int J Radiat Oncol Biol Phys. 2022;113(3):588–593.
2. Lawrence YR, et al. Celiac plexus radiosurgery for pain management in advanced cancer: An international phase II trial, health-related quality of life (HRQOL) outcomes. Abstract 662, ASCO-GI 2023, San Francisco, CA, USA, 19-21 January.
3. Lawrence YR, et al. Int J Radiat Oncol Biol Phys. 2022;114(5):1060–1061.

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Posted on 17 March 202317 May 2024