Computed tomography-guided splanchnic nerve neurolysis outcomes by tumor site in unresectable pancreatic cancer: A single-center retrospective cohort study
Abstract
BACKGROUND: Computed tomography (CT)-guided neurolytic splanchnic nerve block (NSNB) is used to treat pain in unresectable pancreatic cancers. Whether outcomes differ according to tumor site remains uncertain.
AIM: To evaluate the efficacy and safety of CT-guided NSNB in unresectable pancreatic cancer and explore differences by tumor site.
METHODS: This single-center retrospective cohort study included 22 patients who underwent initial CT-guided NSNB at the Oita Red Cross Hospital between 2007 and 2023. Clinical success comprised recorded pain relief or opioid reduction within 1 week; standardized pain scores were not routinely recorded. Technical success required bilateral retrocrural distribution. Adverse events were graded using the Common Terminology Criteria for Adverse Events (CTCAE). Proportions were reported with 95% confidence intervals (95%CIs); comparisons used Fisher’s exact and exact permutation Mann-Whitney U tests.
RESULTS: Technical and clinical success occurred in 17/22 (77.3%; 95%CI: 56.6%-89.9%) and 18/22 (81.8%; 95%CI: 61.5%-92.7%), respectively. The recorded duration was available for 13 clinical responders, with a median of 40 days (interquartile range: 19-144 days); four transfers and one death lacked an evaluable duration. The clinical success rates were 6/9 for head tumors and 12/13 for body/tail tumors. The available duration medians were 29.5 days and 117 days, respectively. Adverse events occurred in 6/22 (27.3%; 95%CI: 13.2%-48.2%), with no CTCAE grade ≥ 3 events.
CONCLUSION: CT-guided NSNB is associated with encouraging clinical responses at both tumor sites in this small retrospective cohort. Prospective studies should confirm these findings and clarify potential tumor-site differences.
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BibTeX
@article{baba2026computed,
title = {{Computed tomography-guided splanchnic nerve neurolysis outcomes by tumor site in unresectable pancreatic cancer: A single-center retrospective cohort study}},
author = {Hiroshi Baba and Hajime Takaki and Yasunari Yamada and Tomoko Nakayama and Kentaro Iwaki and Kengo Fukuzawa and Mitsuteru Motomura and Yoshiki Asayama},
journal = {World journal of radiology},
year = {2026},
month = oct,
doi = {10.4329/wjr.126066},
url = {https://europepmc.org/article/PMC/PMC13720563},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Computed tomography-guided splanchnic nerve neurolysis outcomes by tumor site in unresectable pancreatic cancer: A single-center retrospective cohort study
AU - Hiroshi Baba
AU - Hajime Takaki
AU - Yasunari Yamada
AU - Tomoko Nakayama
AU - Kentaro Iwaki
AU - Kengo Fukuzawa
AU - Mitsuteru Motomura
AU - Yoshiki Asayama
PY - 2026
DA - 2026/10/28
JO - World journal of radiology
DO - 10.4329/wjr.126066
UR - https://europepmc.org/article/PMC/PMC13720563
AB - BACKGROUND: Computed tomography (CT)-guided neurolytic splanchnic nerve block (NSNB) is used to treat pain in unresectable pancreatic cancers. Whether outcomes differ according to tumor site remains uncertain. AIM: To evaluate the efficacy and safety of CT-guided NSNB in unresectable pancreatic cancer and explore differences by tumor site. METHODS: This single-center retrospective cohort study included 22 patients who underwent initial CT-guided NSNB at the Oita Red Cross Hospital between 2007 and 2023. Clinical success comprised recorded pain relief or opioid reduction within 1 week; standardized pain scores were not routinely recorded. Technical success required bilateral retrocrural distribution. Adverse events were graded using the Common Terminology Criteria for Adverse Events (CTCAE). Proportions were reported with 95% confidence intervals (95%CIs); comparisons used Fisher’s exact and exact permutation Mann-Whitney U tests. RESULTS: Technical and clinical success occurred in 17/22 (77.3%; 95%CI: 56.6%-89.9%) and 18/22 (81.8%; 95%CI: 61.5%-92.7%), respectively. The recorded duration was available for 13 clinical responders, with a median of 40 days (interquartile range: 19-144 days); four transfers and one death lacked an evaluable duration. The clinical success rates were 6/9 for head tumors and 12/13 for body/tail tumors. The available duration medians were 29.5 days and 117 days, respectively. Adverse events occurred in 6/22 (27.3%; 95%CI: 13.2%-48.2%), with no CTCAE grade ≥ 3 events. CONCLUSION: CT-guided NSNB is associated with encouraging clinical responses at both tumor sites in this small retrospective cohort. Prospective studies should confirm these findings and clarify potential tumor-site differences.
SN - 1949-8470
ER -