Pain in pancreatic ductal adenocarcinoma: a multidisciplinary, International guideline for optimized management (2018)
- Authors:
- Autor USP: SALVETTI, MARINA DE GÓES - EE
- Unidade: EE
- Sigla do Departamento: ENC
- DOI: 10.1016/j.pan.2018.04.008
- Subjects: DOR; PANCREATOPATIAS; NEOPLASIAS PANCREÁTICAS; ANALGÉSICOS; CIRURGIA; ENDOSCOPIA; RADIOTERAPIA
- Language: Inglês
- Abstract: Abdominal pain is an important symptom in most patients with pancreatic ductal adenocarcinoma(PDAC). Adequate control of pain is often unsatisfactory due to limited treatment options and significantvariation in local practice, emphasizing the need for a multidisciplinary approach. This review contendsthat improvement in the management of PDAC pain will result from a synthesis of best practice andevidence around the world in a multidisciplinary way. To improve clinical utility and evaluation, theevidence was rated according to the GRADE guidelines by a group of international experts. An algorithmis presented, which brings together all currently available treatment options. Pain is best treated early onwith analgesics with most patients requiring opioids, but neurolytic procedures are often required laterin the disease course. Celiac plexus neurolysis offers medium term relief in a substantial number ofpatients, but other procedures such as splanchnicectomy are also available. Palliative chemotherapy alsoprovides pain relief as a collateral benefit. It is stressed that the assessment of pain must take into ac-count the broader context of other physical and psychological symptoms. Adjunctive treatments for pain,depression and anxiety as well as radiotherapy, endoscopic therapy and neuromodulation may berequired in selected patients. There are few comparative studies to help define which combination andorder of these treatment options should be applied. New pain therapies are emerging and could forexample target neural transmitters. However, until better methods are available, management of painshould be individualized in a multidisciplinary setting to ensure optimal care
- Imprenta:
- Source:
- Título: Pancreatology
- ISSN: 1424-3903
- Volume/Número/Paginação/Ano: v. 18, p. 446-457, 2018
- Status:
- Artigo aberto em periódico híbrido (Hybrid Open Access)
- Versão do Documento:
- Versão publicada (Published version)
- Acessar versão aberta:
-
ABNT
DREWES, Asbjørn M et al. Pain in pancreatic ductal adenocarcinoma: a multidisciplinary, International guideline for optimized management. Pancreatology, v. 18, p. 446-457, 2018Tradução . . Disponível em: https://doi.org/10.1016/j.pan.2018.04.008. Acesso em: 05 maio 2026. -
APA
Drewes, A. M., Campbell, C. M., Ceyhan, G. O., Delhaye, M., Garg, P. K., Goor, H. van, et al. (2018). Pain in pancreatic ductal adenocarcinoma: a multidisciplinary, International guideline for optimized management. Pancreatology, 18, 446-457. doi:10.1016/j.pan.2018.04.008 -
NLM
Drewes AM, Campbell CM, Ceyhan GO, Delhaye M, Garg PK, Goor H van, Laquente B, Morlion B, Olesen SS, Singh VK, Sjøgren P, Szigethy E, Windsor JA, Salvetti M de G, Talukdar R. Pain in pancreatic ductal adenocarcinoma: a multidisciplinary, International guideline for optimized management [Internet]. Pancreatology. 2018 ; 18 446-457.[citado 2026 maio 05 ] Available from: https://doi.org/10.1016/j.pan.2018.04.008 -
Vancouver
Drewes AM, Campbell CM, Ceyhan GO, Delhaye M, Garg PK, Goor H van, Laquente B, Morlion B, Olesen SS, Singh VK, Sjøgren P, Szigethy E, Windsor JA, Salvetti M de G, Talukdar R. Pain in pancreatic ductal adenocarcinoma: a multidisciplinary, International guideline for optimized management [Internet]. Pancreatology. 2018 ; 18 446-457.[citado 2026 maio 05 ] Available from: https://doi.org/10.1016/j.pan.2018.04.008 - Terapia cognitivo-comportamental
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