Clinical trial · Interventional
Upfront EUS CGN/CPN vs Conventional Step up Approach for Inoperable Painful Pancreatic Cancer
Upfront Endoscopic Ultrasound-guided Celiac Ganglion Neurolysis Versus Conventional Step-up Approach for Patients With Painful, Inoperable Pancreatic Cancer
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Patients with unresectable pancreatic cancer are often demoralized by intractable, persistent and incapacitating pain. It must be managed aggressively and strong opioids are recommended as the mainstay of treatment. However, patients develop opioid-related adverse effects. EUS-guided celiac plexus neurolysis (CPN) and celiac ganglion neurolysis (CGN) has been shown to provide high efficacy for pain control. The optimal timing, however, is in debate.
Conditions
Conditions (3)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Pain Cancer | — | UNRESOLVED | — |
| Pancreatic Cancer Non-resectable | — | UNRESOLVED | — |
| Tumor Pancreas | — | UNRESOLVED | — |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| EUS-guided coeliac ganglion neurolysis / celiac plexus neurolysis | Procedure | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- type
- ACTIVE_COMPARATOR
- label
- EUS-guided coeliac ganglion neurolysis / celiac plexus neurolysis
- description
- Patient would undergo a EUS diagnostic procedure with or without a biopsy. Patient would be blinded to the group they were assigned. The procedure will be performed with a linear array echoendoscope (EUS) under conscious sedation or monitored anaesthesia care. For cases in which celiac ganglia could not be visualized, EUS-guided coeliac plexus neurolysis (CPN) will be performed.
- interventionNames
- Procedure: EUS-guided coeliac ganglion neurolysis / celiac plexus neurolysis
- type
- ACTIVE_COMPARATOR
- label
- Conventional step-up approach
- description
- Patient would undergo a EUS diagnostic procedure with or without a biopsy. Patient would be blinded to the group they were assigned. The concept of the conventional step-up approach is to follow ESMO clinical practice guidelines for cancer pain. In case of inadequate pain control, the analgesics will be stepped up according to the guidelines. After 4 weeks, if patient's VAS score more than 7 or VAS score fails to improve by 20% despite optimal oral analgesics, patients are given the option of EUS-guided CGN/ CPN.
- interventionNames
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: 1. Age \>= 18 years old 2. Diagnosed to have inoperable pancreatic cancer 3. Presence of tumor pain (centrally located, constant, with no other obvious cause) with a VAS \>= 3 4. Karnofsky performance status \>= 60 5. Planned for EUS examination and/or biopsy of the pancreatic tumor Exclusion Criteria: 1. Allergy to bupivacaine, or alcohol 2. Potentially operable after neoadjuvant therapy 3. Expected survival of less than 3 months 4. Patient who is already on opioids for pain control 5. Previous percutaneous or EUS-guided CGN/ CPN 6. Recurrent pancreatic tumors after operation 7. Uncorrectable coagulopathy 8. Inability or unwillingness to provide informed consent
References
Publications (0)
Data not yet available