Computerized Tomography-Guided Radiofrequency Cingulotomy for Intractable Cancer Pain: A Case Report and Literature Review

電腦斷層導引立體定位扣帶回燒灼術治療難控制的癌症疼痛：病例報告及文獻回顧

楊嵐怡(Lan-Yi Yang) ； 郭集慶(Victor C. Kok) ； 蘇育德(Yu-Deh Su) ； 楊鴻振(Hung-Chen Yang) ； 顏華正(H-C Yen)

《安寧療護雜誌》 6卷4期 (2001/11) Pp. 13-21

https://doi.org/10.6537/TJHPC.2001.6(4).2

摘要

病例報告：本例係將對鴉片類藥物療效不佳的惡性腦瘤患者，施以電腦斷層導引下立體定位扣帶回燒灼術治療。結論：扣帶回燒灼術主要目的乃係在於有效地降低疼痛並減少鴉片對患者的副作用。約有50%遭受癌症疼痛困擾的病患，再施以扣帶回燒灼術三個月後，其疼痛顯著地降低甚至完全解除。扣帶回燒灼術的風險與成效曾引起廣泛的討論。多數文獻中都指出扣帶回燒灼術對於癌症疼痛控制是有效而且安全。

關鍵字

立體定位扣帶回燒灼術 ； 癌症疼痛 ； 難控制疼痛

並列摘要

A Taiwanese male patient with heavily pretreated and refractory glioblastoma multiforme reporting excruciating pain that responded poorly to opioids was treated with computerized tomography-guided stereotactic bilateral radiofrequency cingulotomy. Prompt pain relief was achieved rapidly and his opioid use could be tapered later to preserve adequate consciousness in his remaining life. Radiofrequency cingulotomy was reported to produce significant pain relief and reduced opioid use. In patients with intractable cancer pain treated with cingulotomy, approximately 50% obtained moderate, marked or complete pain relief for the ensuing three months. The potential risks and the benefits of cingulotomy are discussed. The outcomes of treatment in the literature review suggest that cingulotomy may be effective and safe for intractable cancer pain control especially in the setting of hospice palliative care.

並列關鍵字

radiofrequency cingulotomy ； intractable pain ； cancer pain ； palliative care ； cancer