ReviewSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2015
Pharmacological options for the management of refractory cancer pain-what is the evidence?
Review in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 6 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Effectiveness of percutaneous cervical cordotomy in intractable cancer pain: a systematic review and meta-analysis.Neurosurgical review · 2026Pooled it
- Spinal analgesia in cancer pain management-MASCC general practice recommendations.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Guideline
- Parenteral Lidocaine for Complex Cancer Pain in the Home or Inpatient Hospice Setting: A Review and Synthesis of the Evidence.Journal of palliative medicine · 2021Pooled it
- Opioid Rotation in Cancer Pain Treatment.Deutsches Arzteblatt international · 2018Pooled it
- Ketamine as an adjuvant to opioids for cancer pain.The Cochrane database of systematic reviews · 2017Pooled it
- Interventional options for the management of refractory cancer pain--what is the evidence?Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2016Pooled it
- Methadone versus other opioids for refractory malignant bone pain: a pilot randomised controlled study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Trial
- Evidence-Based Nursing Management of Semi-Implantable Intrathecal Drug Delivery Systems for Refractory Cancer Pain: Protocol Development and Clinical Evaluation.Nursing & health sciences · 2026Article
- Current implementation and perception of palliative interventional radiology procedures for patients with refractory cancer pain among interventional radiologists in Japan: a nationwide survey.Japanese journal of radiology · 2026Article
- Article
- Efficacy and safety of single and double catheter intrathecal drug delivery systems in patients with refractory neck and abdominal cancer pain.Scientific reports · 2024Article
- A nationwide neurosurgical inter-disciplinary service for cancer-related refractory pain.BMC palliative care · 2024Article
- Refractory Cancer Pain and Intrathecal Therapy: Critical Review of a Systematic Review.Pain and therapy · 2023Review
- Methadone rotation versus other opioid rotation for refractory cancer induced bone pain: protocol of an exploratory randomised controlled open-label study.BMC palliative care · 2023Article
- Comparison of external system and implanted system in intrathecal therapy for refractory cancer pain in China: A retrospective study.Brain and behavior · 2023Article
- Early Interventional Treatments for Patients with Cancer Pain: A Narrative Review.Journal of pain research · 2023Review
- Using a multimodal approach to manage difficult visceral cancer pain: A case study.SAGE open medical case reports · 2023Article
- The role of methadone in cancer-induced bone pain: a retrospective cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Percutaneous cervical cordotomy for cancer-related pain: national data.BMJ supportive & palliative care · 2020Article
- A rapid positive influence of S-ketamine on the anxiety of patients in palliative care: a retrospective pilot study.BMC palliative care · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Refractory cancer pain that does not respond to standard opioid and/or co-analgesic therapy occurs in 10-20 % of patients. Risk factors include young age, neuropathic pain type, incident pain, psychological distress, previous opioid use, high tolerance, a history of addiction and impaired cognition. The management of patients with refractory pain remains a challenge. Treatment options include opioid manipulation (parenteral delivery, rotation, combination, methadone and buprenorphine), non-opioids and co-analgesics (paracetamol, non-steroidal anti-inflammatory agents, antidepressants and anticonvulsants), NMDA receptor antagonists, cannabinoids, lignocaine and corticosteroids. The evidence of benefit for any of these agents is weak, and each additional agent increases the risk of adverse events. Evidence-based guidelines cannot, therefore, be developed at present. New approaches are recommended including targeted opioid therapy, multimodal analgesia, a goal-oriented approach to pain management and increasing use of the multidisciplinary team and support services.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.