Abstract
BACKGROUND: Advanced cancer pain, especially in pancreatic cancer, often requires interventional management. This meta-analysis evaluates the effectiveness and safety of celiac plexus radiotherapy in reducing pain, providing comprehensive insights for oncologic pain management. METHODS: A systematic search was conducted on PubMed, Embase, and Cochrane databases through October 2024. The primary outcome was the BPI-SF (Brief Pain Inventory-Short Form) pain score reduction at 3 weeks. Data were analyzed using random-effects models, with heterogeneity assessed by I (2) statistics and publication bias evaluated via funnel plots, all conducted in R software 4.3.3. RESULTS: This meta-analysis included 4 randomized controlled trials with 141 participants, median age 64.25 years. Most patients (91.75%) had pancreatic cancer. BPI-SF pain scores showed significant reductions at 3 weeks (RR -4.59, 95% CI: -7.77 to -1.42, P < 0.001, I (2) = 99%) and at 6 weeks (RR -2.35, 95% CI: -4.16 to -0.63, P < 0.01, I (2) = 98%). Morphine use showed no significant change at 3-week post-procedure. Celiac plexus radiosurgery demonstrated a favorable safety profile, with mild-to-moderate adverse events like fatigue (59.5%), abdominal pain (38%), and nausea (40.3%), and a few severe events (28% abdominal pain). CONCLUSION: Celiac plexus radiotherapy appears effective in reducing cancer-related pain at 3- and 6-week post-procedure with minimal impact on morphine use. It demonstrates a favorable safety profile, making it a promising option for managing advanced cancer pain.