title: Considerations for evaluating the use of intrathecal drug delivery in the oncologic patient.
abstract: While the majority of cancer pain patients are successfully managed with conservative medical management, some patients may suffer from intractable pain or intolerable side effects. The implantation of an intrathecal drug delivery system offers many advantages to improve both analgesia and side effect profile. Practitioners may decide to proceed toward implantation after appropriate patient selection, and, when applicable, a suitable trial for the device. Once implantation is completed, multiple medication combinations may be used to optimize the therapeutic benefit of the device. We describe a stepwise paradigm to implement an intrathecal drug delivery program in the cancer pain population.
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA, gulatia@mskcc.org.
authors.forename: Amitabh
authors.initials: A
authors.lastname: Gulati
authors.forename: Vinay
authors.initials: V
authors.lastname: Puttanniah
authors.forename: Joseph
authors.initials: J
authors.lastname: Hung
authors.forename: Vivek
authors.initials: V
authors.lastname: Malhotra
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D018579:Patient Selection
chemical_list: D000701:Analgesics, Opioid