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Background: Little is known about the effects of pancreatic cryoablation (PCA) on abdominalgia in patients with pancreatic cancer or its synergism with celiac plexus block (CPB). We investigated the pain-alleviating effects of PCA plus CPB in patients with abdominalgia compared with the effect of PCA alone in patients without abdominalgia. Methods: Sixty-two patients were enrolled in this retrospective review; 12 without abdominalgia refused PCA, 15 without abdominalgia received PCA to reduce their tumour load, and 35 with abdominalgia received PCA plus CPB to reduce tumour load and alleviate pain. Findings: All PCA and PCA plus CPB procedures were performed successfully. Some slight adverse effects (e.g., increased serum amylase, abdominal distension, nausea, and abdominal bleeding) had disappeared by 3weeks, spontaneously or after symptomatic treatment. In patients without abdominalgia, pain occurred in a third of cases (all with pancreatic head cancer) after PCA but had stopped 1-12days after treatment; in patients with abdominalgia before treatment, pain stopped immediately after PCA plus CPB in 18 cases and 2-24days after treatment in 17 (all with pancreatic head cancer); a significant difference was found between pre-treatment and post-treatment pain frequency (p=0.0019), regardless of the presence of advanced (p=0.0096) or metastatic (p=0.0072) cancer. The average time to pain relief was approximately 7days after both PCA and PCA plus CPB, and abdominalgia did not recur for more than 8weeks. Interpretation: PCA may cause short-term pain in some patients with pancreatic cancer. Combined PCA and CPB can alleviate cancer pain for more than 8weeks, without severe side effects. [ABSTRACT FROM AUTHOR]

Background: We sought to investigate the analgesic effect of cryosurgery on bone-tumour-induced pain. Methods: Thirty-four patients with bone malignancy were given percutaneous cryosurgery 43 times. Bone biopsies and PET-CT were performed to observe metabolic activity after cryosurgery. NRS scores were recorded and analysed to evaluate the pain-killing effect of cryosurgery. Findings: After cryosurgery most of the metastatic foci (10 of 13) showed necrosis. Seven of nine showed significant inhibition of metabolism and two showed partial inhibition. 3days after cryosurgery, NRS scores indicated a complete response of pain in 18 patients (53%), partial response in 10 patients (29%), stable disease in four patients (12%), and progressive disease in two patients (6%). At 10days after cryosurgery, complete response of pain was seen in 25 patients (74%), partial response in six patients (18%), stable disease in two patients (6%), and progressive disease in one patient (3%). Twenty (59%) major complications were observed, including 12 cases of local subcutaneous dropsy, one case of skin necrosis over a local small area, and seven cases of fever; no fracture occurred during the hospitalisations. Six patients died at 34, 58, 69, 88, 105days, and 16months, respectively, after cryosurgery. Among them, two patients died of dyscrasia failure, one died of airway obstruction and lung infection, one died of encephalic metastasis, and two died of liver and renal failure. No cause of death was directly related to cryosurgery. The remission time of pain of other patients was 46-232days, median time was 128days. Nine patients' tumours (27%) were recurrent or had a progressive destruction of bone. Interpretation: Cryosurgery can be accepted as a relatively safe and effective procedure for the palliative treatment of bone tumours, especially for stopping pain. [ABSTRACT FROM AUTHOR]