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Title: Implantabilne intratekalne črpalke za refraktarno rakavo bolečino : prospektivna pilotna raziskava Authors: ID Zupanc, Teodora (Author) ID Stražišar, Branka (Author) ID Škorjanc, Aljoša (Author) ID Šporin, Martin (Author) ID Potočnik, Iztok (Author) Files: PDF - Presentation file, download (367,36 KB) MD5: 396360FB65DC339DAFC8D97F8961B014   Language: Slovenian Typology: 1.01 - Original Scientific Article Organization: OI - Institute of Oncology Abstract: Rakava bolečina je pogosto neustrezno obravnavana s standardnimi sistemskimi terapijami. Ciljna intratekalna aplikacija zdravil z implantabilnimi (vsajenimi) intratekalnimi črpalkami lahko izboljša analgezijo in zmanjša sistemske neželene učinke, vendar lahko zdravljenje z zunanjimi črpalkami pomembno obremeni bolnika in njegove svojce zaradi potrebe po pogostem menjavanju rezervoarjev z zdravili. Poleg tega je lahko zunanja črpalka moteča in bolnika ovira pri vsakodnevnih dejavnostih. V zadnjem času se vse bolj uveljavljajo implantabilne intratekalne črpalke, ki se vstavijo v podkožje. Te omogočajo uporabo visoko koncentriranih učinkovin in redkejše polnjenje, kar lahko bistveno izboljša kakovost življenja. Izvedli smo prospektivno pilotno raziskavo, v katero smo vključili osem bolnikov z napredovalim rakom in refraktarno bolečino. Dva bolnika sta prejemala protibolečinsko terapijo z implantabilno intratekalno črpalko, šest pa s pomočjo subkutane črpalke. Intenzivnost bolečine in kakovost življenja smo ocenjevali z uporabo lestvice vizualne analogne skale (VAS, Visual Analogue Scale), lestvice za oceno simptomov pri napredovali bolezni (ESAS, Edmonton Symptom Assessment System) ter vprašalnika za kakovost življenja Evropske organizacije za raziskave in zdravljenje raka (EORTC QLQ-C30, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire). Ocenjevanje je potekalo v prvih štirih tednih po uvedbi črpalke. Zdravljenje z intratekalnimi črpalkami je bilo povezano s hitrejšim in trajnejšim zmanjšanjem bolečine v primerjavi s subkutanimi črpalkami. Pri bolnikih z intratekalnimi črpalkami smo opazili boljše splošno zdravstveno stanje, ugodnejše funkcionalne in simptomatske profile ter manjšo incidenco neželenih učinkov zdravljenja. Implantabilne intratekalne črpalke lahko pri skrbno izbranih bolnikih z refraktarno rakavo bolečino omogočajo učinkovitejši nadzor bolečine ter pomembno izboljšajo kakovost življenja v primerjavi s subkutano aplikacijo. Za dokončno potrditev teh ugotovitev so potrebne obsežnejše, dobro zasnovane prospektivne študije. Keywords: intratekalne črpalke, bolečina, onkologija Publication status: Published Publication version: Version of Record Publication date: 01.06.2026 Publisher: Onkološki inštitut Year of publishing: 2026 Number of pages: str. 34-43 Numbering: Letn. 30, št. 1 Source: Ljubljana PID: 20.500.12556/DiRROS-31376  UDC: 616-006 ISSN on article: 1408-1741 DOI: 10.25670/oi2026-004on  COBISS.SI-ID: 282373891  Copyright: by Authors Publication date in DiRROS: 30.07.2026 Views: 32 Downloads: 8 Metadata:    Cite this work Plain text BibTeX EndNote XML EndNote/Refer RIS ABNT ACM Ref AMA APA Chicago 17th Author-Date Harvard IEEE ISO 690 MLA Vancouver : Copy citation

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Record is a part of a journal

Title:	Onkologija
Shortened title:	Onkologija
Publisher:	Onkološki inštitut
ISSN:	1408-1741
COBISS.SI-ID:	65324032

Licences

License:	CC BY 4.0, Creative Commons Attribution 4.0 International
Link:	http://creativecommons.org/licenses/by/4.0/
Description:	This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

Language:	English
Title:	Implantable intrathecal pumps for refractory cancer pain : a prospective pilot study
Abstract:	Cancer pain is often inadequately managed with standard systemic therapies. Targeted intrathecal administration of analgesics via implantable (internal) intrathecal pumps may improve analgesia and reduce systemic adverse effects. However, treatment with external pumps may place a substantial burden on patients and their caregivers due to the frequent need for medication reservoir refills. In addition, external pumps can be cumbersome and may interfere with patients’ daily activities. Recently, implantable intrathecal pumps placed in the subcutaneous tissue have become increasingly used. These devices allow the administration of highly concentrated drug solutions and less frequent refilling, which may significantly improve quality of life. We conducted a prospective pilot study including eight patients with advanced cancer and refractory pain. Two patients received analgesic therapy via an implantable intrathecal pump, while six were treated using a subcutaneous pump. Pain intensity and quality of life were assessed using the Visual Analogue Scale (VAS), the Edmonton Symptom Assessment System (ESAS), and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Assessments were performed during the first four weeks after pump implantation. Intrathecal pump therapy was associated with a faster and more sustained reduction in pain compared with subcutaneous pumps. Patients treated with intrathecal pumps demonstrated better overall health status, more favourable functional and symptom profiles, and a lower incidence of treatment-related adverse effects. Implantable intrathecal pumps may enable more effective pain control and significantly improve quality of life in carefully selected patients with refractory cancer pain compared with subcutaneous administration. Larger, well-designed prospective studies are needed to confirm these findings.

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