Endoscopic ultrasound-guided celiac plexus block (EUS-CPB) is under investigation as a method for pain palliation in patients suffering from pancreatic cancer. A multi-center, randomized controlled trial is currently ongoing to rigorously evaluate the efficacy of EUS-CPB in comparison to standard pain management strategies. The study is designed to determine whether EUS-CPB can effectively reduce pain intensity and enhance the overall quality of life for individuals diagnosed with pancreatic cancer.
Study Design and Objectives
The prospective, randomized controlled trial is actively enrolling participants across multiple centers within the US Pancreatic Disease Study Group. Patients with confirmed pancreatic cancer experiencing significant abdominal pain are being randomized to either the EUS-CPB intervention arm or the standard pain management control arm. The primary outcome measure is the change in pain intensity, assessed using a visual analog scale (VAS), at various time points post-intervention. Secondary outcomes include assessments of quality of life, opioid consumption, and adverse events.
The trial incorporates a standardized EUS-CPB protocol, involving the injection of local anesthetic and corticosteroid agents into the celiac plexus under real-time ultrasound guidance. The control arm receives standard pain management, which may include opioid analgesics, non-opioid analgesics, and other supportive care measures, as determined by the treating physician.
Potential Clinical Implications
Pancreatic cancer is a devastating disease often associated with severe abdominal pain, significantly impacting patients' quality of life. Current pain management strategies, primarily relying on opioid analgesics, can be limited by side effects and the potential for tolerance and dependence. EUS-CPB represents a minimally invasive approach to target the source of pain transmission, potentially offering improved pain control with reduced reliance on systemic medications.
If the trial demonstrates a significant benefit of EUS-CPB in reducing pain and improving quality of life, it could establish EUS-CPB as a valuable alternative or adjunct to traditional pain management methods for pancreatic cancer patients. Further research will be needed to optimize the technique, identify ideal patient candidates, and assess the long-term efficacy and safety of EUS-CPB in this challenging patient population.
