title: Palliation of intractable cancer pain by MRI-guided cingulotomy.
abstract: METHODS
  Three cases of intractable pain arising from widespread metastatic cancer with poor response to opioids were treated with MRI-guided cingulotomy.
  
  
  CONCLUSIONS
  In most cases, MRI-guided cingulotomy was associated with significant pain relief and reduced opioid use. To provide insight into the role of MRI-guided cingulotomy in oncologic pain refractory to more conservative measures, the relative risks and benefits of cingulotomy are discussed, along with the course of one patient who experienced postoperative cognitive impairment. This report also describes the relevant neurosurgical and pharmacotherapeutic issues associated with management of pain in patients with widespread metastatic disease.
authors.affiliation: Department of Neuro-Oncology, University of Texas, M. D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: E T
authors.initials: ET
authors.lastname: Wong
authors.forename: S
authors.initials: S
authors.lastname: Gunes
authors.forename: E
authors.initials: E
authors.lastname: Gaughan
authors.forename: R B
authors.initials: RB
authors.lastname: Patt
authors.forename: L E
authors.initials: LE
authors.lastname: Ginsberg
authors.forename: S J
authors.initials: SJ
authors.lastname: Hassenbusch
authors.forename: R
authors.initials: R
authors.lastname: Payne
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000150:complications; D018281:Cholangiocarcinoma / Q000150:complications; D005260:Female; D006179:Gyrus Cinguli / Q000033:anatomy & histology / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000150:complications; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010148:Intractable Pain / Q000209:etiology / Q000628:therapy*; D010166:Palliative Care