The following is a summary of “Implanted intrathecal drug delivery systems may be associated with improved survival in patients with cancer,” published in the October 2023 issue of Pain by Mitchell et al.
Intrathecal drug delivery systems (IDDS) are underused to treat cancer pain, although they are effective and can improve survival. We don’t know which patients benefit most from IDDS. Researchers started a retrospective study to describe the baseline characteristics and survival outcomes of patients who received, declined, or could not receive IDDS for cancer pain.
They examined the survival data of 75 consecutive patients offered intrathecal drug delivery as part of a retrospective cohort study. The survival data was compared across three groups: those who accepted intrathecal drug delivery and received it (n = 41), those who took it but experienced deterioration before commencement (n = 17), and those who declined this treatment modality (n = 17).
The results showed patients who received IDDS had a significantly longer survival following assessment compared to those who declined IDDS (with a hazard ratio (HR) for the IDDS group relative to the rejected group of 0.29 (95% CI 0.16 to 0.53) and 0.23 (95% CI 0.12 to 0.44) after adjusting for gender and baseline functional status. For patients who accepted IDDS but couldn’t initiate treatment, survival after assessment was not significantly different from those who declined IDDS (with an HR for the deteriorated group relative to the reduced group of 1.28 (95% CI 0.65 to 2.53) and 0.80 (95% CI 0.65 to 2.53) after adjusting for gender and baseline functional status).
They concluded that Implanted intrathecal drug delivery systems may improve survival in patients with cancer pain.