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Abstract
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Background and Aims Intrathecal Drug Delivery Systems (IDDS) provide targeted pain relief by delivering medication directly to the spinal cord, benefiting patients who do not respond to conventional treatments or experience severe side effects. However, the effectiveness and response patterns to IDDS between cancer-related and chronic non-cancer pain patients remain largely unexplored. This study aimed to compare the efficacy of IDDS between patients with cancer-related pain (C group) and those with chronic non-cancer pain (NC group).
Methods Intrathecal Drug Delivery Systems (IDDS) provide targeted pain relief by delivering medication directly to the spinal cord, benefiting patients unresponsive to conventional treatments or experiencing severe side effects. However, the effectiveness and response patterns of IDDS between cancer-related and chronic non-cancer pain patients remain largely unexplored. This study compared the efficacy of IDDS in patients with cancer-related pain (C group) and chronic non-cancer pain (NC group).
Results Both groups showed significant increases in MEDD from baseline to 1-year post-implantation, with the C group requiring higher doses throughout the study period (figure 1). Similarly, both groups exhibited significant reductions in VAS scores; however, group C experienced greater and more sustained pain reduction (figure 2). A higher proportion of patients (42.9%) in the C group achieved a 50% or greater reduction in pain at 6 months compared with the NC group (12%, P = 0.04).
Changes in MEDD (morphine equivalent daily dose, mg) in C (cancer) and NC (non-cancer) groups. Both groups showed an increase in MEDD from baseline to 1 year. The C group had a significantly higher MEDD than the NC group at each time point. Error bar indicates standard deviation. *Significant at P < 0.001, compared to the baseline MEDD. †Significant at P ≤ 0.01 between C and NC groups
Changes in visual analog scale (VAS) scores (0= no pain, 10= the worst pain imaginable) for pain between C (cancer) and NC (non-cancer) groups. Both groups showed a decrease in pain scores from baseline to 1 year. The C group had a significantly lower VAS score than the NC group at 3 and 6 months, and 1 year. Error bar indicates standard deviation. *Significant at P < 0.001, compared to the baseline VAS score. †Significant at P ≤ 0.01 between C and NC groups
Conclusions The patterns of pain control and changes in MEDD differed between the groups. Our findings suggest that while IDDS benefits cancer pain, its use in chronic non-cancer pain should be approached cautiously.