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Breaking the pain barrier: implantable intrathecal pump therapy as a game-changer in cancer pain management Cover

Breaking the pain barrier: implantable intrathecal pump therapy as a game-changer in cancer pain management

Open Access
|Dec 2025

Figures & Tables

FIGURE 1.

Updated WHO analgesic ladder. Stepwise model of cancer pain management, progressing from NSAIDs to intrathecal and neurosurgical interventions.IDDS = intrathecal drug delivery system; NRS = Numerical Rating Scale; NSAIDs = nonsteroidal anti-inflammatory drugs; PCA = patient-controlled analgesia; VAS = Visual Analogue Scale; WHO = World Health Organization
Updated WHO analgesic ladder. Stepwise model of cancer pain management, progressing from NSAIDs to intrathecal and neurosurgical interventions.IDDS = intrathecal drug delivery system; NRS = Numerical Rating Scale; NSAIDs = nonsteroidal anti-inflammatory drugs; PCA = patient-controlled analgesia; VAS = Visual Analogue Scale; WHO = World Health Organization

Improvement in patients symptoms shown by r-ESAS questionnaire_ Each symptom is rated on a scale from 0 to 10, with a higher value indicating a more severe symptom

ParameterBefore (0-10)After 3 months (0-10)
VAS (Pain)50
Fatigue30
Dizziness30
Nausea20
Inappetence10
Dyspnoea10
Depression40
Anxiety42
Overall Well-Being42

Pharmacological treatment according to the WHO analgesic ladder

Mild painModerate painSevere pain
NSAID Paracetamol MetamizoleTramadol CodeineMorphine Fentanyl Methadone Oxycodone Hydromorphone Buprenorphine Tapentadol

Improvement in patients symptoms shown by EORTC QLQ-C30 questionnaire

CategoryParameterBefore (0-100)After 3 months (0-100)
SymptomsPain83.350
Insomnia10033.3
Appetite Loss66.70
Constipation10066.7
Nausea and Vomiting500
FunctioningPhysical73.380
Role66.7100
Emotional075
Cognitive50100
Social50100
DOI: https://doi.org/10.2478/raon-2025-0060 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 477 - 487
Submitted on: May 9, 2025
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Accepted on: Sep 6, 2025
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Published on: Dec 16, 2025
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2025 Iztok Potocnik, Branka Strazisar, Helena Lenasi, Teodora Zupanc, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.