Douleur chronique cancéreuse et analgésie intrathécale : expérience de trois centres de lutte contre le cancer

The fisrt-line pharmacological treatments of cancer pain are oral analgesics. In some conditions (described in this article), an intrathecal therapy can be useful, but this solution is seldom used in France. We present the results of a French trial realized in three cancer management centers. Ninety-seven patients were included in an analgesic intrathecal infusion study (using an implantable drug delivery system), during 11,981 days of treatment. In the studied population (unstable cancer pain in spite of an optimal oral treatment, rigorous patients' selection), the intrathecal infusion allowed an average relief over 50% of pain (Numeric Scale: N.S.) (3.65 ± 0.46 after one month of treatment versus 7.9 ± 0.27). Linked to well-established (hygienic) guidelines (technical procedures and filling of the pump), the complications were less frequent than in the international literature. This study shows the interest (efficacy and safety) of an intrathecal pump-delivered infusion in selected patients with cancer pain.