Transdiscal versus paravertebral splanchnic nerve neurolysis for upper abdominal cancer pain
Comparison of Transdiscal and Paravertebral Approaches for Neurolytic Splanchnic Nerve Block in the Treatment of Upper Abdominal Cancer Pain
This will test whether the transdiscal or the paravertebral splanchnic nerve neurolysis gives better pain relief for people with severe upper abdominal cancer pain that hasn't responded to medicines.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 56 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Ankara Etlik City Hospital Government |
| Locations | 1 site (Ankara) |
| Trial ID | NCT07445386 on ClinicalTrials.gov |
What this trial studies
This interventional comparison uses fluoroscopy-guided chemical neurolysis to target the splanchnic nerves by either a paravertebral (PV) or a transdiscal (TD) approach in patients with severe upper abdominal cancer pain. Pain intensity will be measured with the Numerical Rating Scale (NRS) and quality of life tracked using the EORTC QLQ-C30 questionnaire before and after the procedures. Eligible patients have NRS > 6 from pancreatic, gastric, or hepatic malignancies and have failed conservative medical treatments; key exclusions include local anatomical variations, infection at the procedural site, coagulopathy, pregnancy, and unstable psychiatric disorders. Procedures and follow-up are conducted at Ankara Etlik City Hospital under fluoroscopic guidance with standard safety monitoring.
Who should consider this trial
Good fit: Adults with severe (NRS > 6) upper intra-abdominal cancer pain (e.g., pancreatic, gastric, hepatic) that is not controlled with medications and who have no contraindications to neurolytic block are ideal candidates.
Not a fit: Patients with coagulopathy, active infection at the procedural site, pregnancy, unstable psychiatric disorders, significant local anatomic variation, or pain not primarily visceral may be excluded or may not benefit from these procedures.
Why it matters
Potential benefit: If successful, the better approach could provide stronger, longer-lasting, opioid-sparing relief of severe upper abdominal cancer pain and improve quality of life.
How similar studies have performed: Splanchnic nerve neurolysis is an established method that has reduced upper abdominal cancer pain and improved quality of life in prior reports, but direct head-to-head comparisons of PV versus TD approaches are limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Severe abdominal pain (NRS \> 6) due to upper intra-abdominal organ malignancies (such as gastric, pancreatic, or hepatic cancer). * Failure of pain control with conservative treatment modalities. Exclusion Criteria: * Presence of local anatomical variations * Localized or systemic infection involving the procedural site * Pregnancy * Coagulopathy * Presence of unstable psychiatric disorders
Where this trial is running
Ankara
- Ankara Etlik City Hospital — Ankara, Turkey (Türkiye) (Recruiting)
Study contacts
- Principal investigator: Gokhan Yildiz — Ankara Etlik City Hospital
- Study coordinator: Gokhan Yildiz
- Email: gkoyldz@gmail.com
- Phone: 5059272589
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.