Upper Abdominal Cancer PainNCT07825870
Outcomes of Fluoroscopy-Guided Transdiscal Splanchnic Nerve Neurolysis for Upper Abdominal Cancer Pain.
A study testing Chemical Neurolysis in people with Upper Abdominal Cancer Pain and Pancreatic Cancer, run by Sahiwal medical college sahiwal at 1 site in Pakistan.
Trial summary
The goal of this prospective study is to learn whether fluoroscopy-guided transdiscal splanchnic nerve neurolysis can safely reduce severe upper abdominal cancer pain in adults with pancreatic, gastric, or hepatobiliary cancer. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Upper Abdominal Cancer Pain, Pancreatic Cancer, Gastric Cancer
- What is being tested?
- Chemical Neurolysis
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 sitePakistan
- Study dates
- 20 Sep 2026to 20 Apr 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥ 18 years. Confirmed diagnosis of pancreatic, gastric, or hepatobiliary malignancy with epigastric/upper abdominal pain.
- Baseline NRS ≥ 7 despite optimized pharmacotherapy, or intolerable opioid side effects.
- ≥ 50% pain relief on diagnostic splanchnic nerve block. Able to provide informed consent.
Who cannot join
- Coagulopathy (INR > 1.5, platelets < 50,000/µL). Local or systemic infection. Uncontrolled hypotension or severe cardiopulmonary compromise precluding prone positioning.
- Intestinal obstruction. Known allergy to contrast, local anesthetic, or the neurolytic agent. Patient refusal.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
Sahiwal Teaching Hospital
Sahiwal, Punjab Province, 57000
Muhammad Shahid, MBBS, FCPS, 923336173056, shahidnishtar@gmail.com
Umer Hussain, MBBS, 923116467002, mumerhussain775@gmail.com
About this study
Official title: Clinical Outcomes and Safety of Fluoroscopy-Guided Transdiscal Splanchnic Nerve Neurolysis in Patients With Upper Abdominal Cancer Pain: A Prospective Cohort Study
The goal of this prospective study is to learn whether fluoroscopy-guided transdiscal splanchnic nerve neurolysis can safely reduce severe upper abdominal cancer pain in adults with pancreatic, gastric, or hepatobiliary cancer. The study will also assess whether this procedure can reduce the need for opioid pain medicines and improve patients' functional status and quality of life.
The main questions it aims to answer are:
Read more
Does the procedure reduce patients' pain one month after treatment?
Does it reduce the amount of opioid pain medication patients need?
Does it improve functional status and quality of life?
What complications or side effects occur after the procedure?
How long does pain relief last, and how often is repeat treatment needed?
Participants will:
First receive a diagnostic splanchnic nerve block with local anesthetic.
If the diagnostic block provides at least 50% pain relief, undergo transdiscal splanchnic nerve neurolysis using fluoroscopy guidance.
Receive a neurolytic agent (absolute alcohol or phenol) through a needle placed at the T11-T12 or T12-L1 level.
Have their pain, opioid medication use, functional status, complications, and satisfaction assessed before treatment and during follow-up.
Complete follow-up assessments at 1 week, 1 month, 3 months, and 6 months after the procedure.
Complete a quality-of-life questionnaire before treatment and at 1 month.
The primary outcome will be the change in pain score on the 0-10 Numeric Rating Scale at 1 month after the procedure.
- Being tested
- Chemical Neurolysis
- Keywords
- Cancer Pain, Upper Abdominal Cancer Pain, Splanchnic Nerve Neurolysis, Transdiscal Splanchnic Nerve Neurolysis, Opioid-Sparing Analgesia
- Medical subject headings
- Pancreatic Neoplasms, Stomach Neoplasms, Cancer Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Chemical NeurolysisProcedure or surgery
Chemical neurolysis will be performed using the study-specified neurolytic agent (alcohol or phenol) to provide pain relief in patients with chronic pain. The procedure will be performed under appropriate clinical and imaging guidance according to the study protocol. Participants will be followed prospectively to assess pain relief, duration of analgesia, functional outcomes, and procedure-related adverse events
| Study group | Role | What they receive |
|---|---|---|
| Chemical Neurolysis | Experimental | Participant will undergo chemical neurolysis using the study specified neurolytic agent for management of chronic pain. the intervention will be administered according to study protocol, with participant followed prospectively for pain relief and treatment related outcomes Receives: Procedure: Chemical Neurolysis |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in pain intensity
Pain intensity will be assessed using the 0-10 Numeric Rating Scale (NRS), where 0 represents no pain and 10 represents the worst imaginable pain. The change in NRS pain score from baseline will be assessed following fluoroscopy-guided transdiscal splanchnic nerve neurolysis.
Measured: Baseline to 1 month after the procedure
Secondary outcomes (3)
Change in quality of life
Quality of life will be assessed using the EORTC QLQ-C30 questionnaire.
Measured: Baseline, 1 month, 3 months, and 6 months
Technical success of neurolysis
Successful completion of fluoroscopy-guided transdiscal splanchnic nerve neurolysis as intended according to the study protocol.
Measured: During the procedure
Opioid consumption
Change in daily opioid consumption expressed as oral morphine milligram equivalents (MME) compared with baseline.
Measured: Baseline, 1 week, 1 month,
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Sep 2026
- Study start20 Sep 2026 (estimated)
- Primary completion20 Mar 2027 (estimated)
- Study completion20 Apr 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (13)Papers the sponsor has linked to this study.
- Other trials for Upper Abdominal Cancer PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Sahiwal medical college sahiwal
- Sponsor type
- Other government
- Responsible party
- Principal investigator, Muhammad Shahid, Sahiwal medical college sahiwal
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07825870
- Sponsor's protocol ID
- SahiwalMed
- Status last verified
- Sep 2026
- First submitted
- 12 Sep 2026
- Last updated
- 17 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007 Oct 20;335(7624):806-8. doi: 10.1136/bmj.39335.541782.AD.
PubMed 17947786Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993 Mar 3;85(5):365-76. doi: 10.1093/jnci/85.5.365.
PubMed 8433390Goyal S, Kumar A, Goyal D, Attar P, Bhandari B, Purohit G, Mahiswar AP, Gupta S. Efficacy of splanchnic nerve neurolysis in the management of upper abdominal cancer pain: A systematic review and meta-analysis. Indian J Anaesth. 2023 Dec;67(12):1036-1050. doi: 10.4103/ija.ija_439_23. Epub 2023 Dec 13.
PubMed 38343676Luo L, Cao X, Qiu M, Zhu M, Yan Y, Zhang D, Zhang X. Splanchnic nerve block via transdiscal and paraspinal approach in the treatment of pain in advanced pancreatic cancer: A randomized controlled trial. Medicine (Baltimore). 2025 Sep 19;104(38):e44250. doi: 10.1097/MD.0000000000044250.
PubMed 40988238Yanaizumi R, Nagamine Y, Harada S, Kuramochi T, Ota S, Abe Y, Nakagawa M, Kamijima K, Hayashi M, Tazawa T, Ogawa K, Goto T. Efficacy and Safety of Neurolytic Splanchnic Nerve Block via Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study. Pain Ther. 2022 Dec;11(4):1359-1372. doi: 10.1007/s40122-022-00432-7. Epub 2022 Sep 28.
PubMed 36169799Cai Z, Zhou X, Wang M, Kang J, Zhang M, Zhou H. Splanchnic nerve neurolysis via the transdiscal approach under fluoroscopic guidance: a retrospective study. Korean J Pain. 2022 Apr 1;35(2):202-208. doi: 10.3344/kjp.2022.35.2.202.
PubMed 35354683Kong YG, Shin JW, Leem JG, Suh JH. Computed Tomography (CT) Simulated Fluoroscopy-Guided Transdiscal Approach in Transcrural Celiac Plexus Block. Korean J Pain. 2013 Oct;26(4):396-400. doi: 10.3344/kjp.2013.26.4.396. Epub 2013 Oct 2.
PubMed 24156008Plancarte-Sanchez R, Mayer-Rivera F, del Rocio Guillen Nunez M, Guajardo-Rosas J, Acosta-Quiroz CO. [Transdiscal percutaneous approach of splanchnic nerves]. Cir Cir. 2003 May-Jun;71(3):192-203. Spanish.
PubMed 14617407Dong D, Zhao M, Zhang J, Huang M, Wang Y, Qi L, Wan CF, Yu X, Song T. Neurolytic Splanchnic Nerve Block and Pain Relief, Survival, and Quality of Life in Unresectable Pancreatic Cancer: A Randomized Controlled Trial. Anesthesiology. 2021 Oct 1;135(4):686-698. doi: 10.1097/ALN.0000000000003936.
PubMed 34398950Shwita AH, Amr YM, Okab MI. Comparative Study of the Effects of the Retrocrural Celiac Plexus Block Versus Splanchnic Nerve Block, C-arm Guided, for Upper Gastrointestinal Tract Tumors on Pain Relief and the Quality of Life at a Six-month Follow Up. Korean J Pain. 2015 Jan;28(1):22-31. doi: 10.3344/kjp.2015.28.1.22. Epub 2015 Jan 2.
PubMed 25589943Zhong W, Yu Z, Zeng JX, Lin Y, Yu T, Min XH, Yuan YH, Chen QK. Celiac plexus block for treatment of pain associated with pancreatic cancer: a meta-analysis. Pain Pract. 2014 Jan;14(1):43-51. doi: 10.1111/papr.12083. Epub 2013 May 20.
PubMed 236827882. International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today-Pakistan. GLOBOCAN 2022. Lyon, France: IARC; 2024
van den Beuken-van Everdingen MH, Hochstenbach LM, Joosten EA, Tjan-Heijnen VC, Janssen DJ. Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis. J Pain Symptom Manage. 2016 Jun;51(6):1070-1090.e9. doi: 10.1016/j.jpainsymman.2015.12.340. Epub 2016 Apr 23.
PubMed 27112310
Study at a glance
From the registry record, last updated by the sponsor on 17 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Clinical Outcomes and Safety of Fluoroscopy-Guided Transdiscal Splanchnic Nerve Neurolysis in Patients With Upper Abdominal Cancer Pain: A Prospective Cohort Study
- ClinicalTrials.gov ID
- NCT07825870
- Acronym / sponsor ID
- SahiwalMed
- Keywords
- Cancer Pain, Upper Abdominal Cancer Pain, Splanchnic Nerve Neurolysis, Transdiscal Splanchnic Nerve Neurolysis, Opioid-Sparing Analgesia
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Sahiwal medical college sahiwalOther government
- Study start
- 20 Sep 2026 (estimated)
- Primary completion
- 20 Mar 2027 (estimated)
- Study completion
- 20 Apr 2027 (estimated)
- First posted
- 17 Sep 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this prospective study is to learn whether fluoroscopy-guided transdiscal splanchnic nerve neurolysis can safely reduce severe upper abdominal cancer pain in adults with pancreatic, gastric, or hepatobiliary cancer. The study will also assess whether this procedure can reduce the need for opioid pain medicines and improve patients' functional status and quality of life.
The main questions it aims to answer are:
Does the procedure reduce patients' pain one month after treatment?
Does it reduce the amount of opioid pain medication patients need?
Does it improve functional status and quality of life?
What complications or side effects occur after the procedure?
How long does pain relief last, and how often is repeat treatment needed?
Participants will:
First receive a diagnostic splanchnic nerve block with local anesthetic.
If the diagnostic block provides at least 50% pain relief, undergo transdiscal splanchnic nerve neurolysis using fluoroscopy guidance.
Receive a neurolytic agent (absolute alcohol or phenol) through a needle placed at the T11-T12 or T12-L1 level.
Have their pain, opioid medication use, functional status, complications, and satisfaction assessed before treatment and during follow-up.
Complete follow-up assessments at 1 week, 1 month, 3 months, and 6 months after the procedure.
Complete a quality-of-life questionnaire before treatment and at 1 month.
The primary outcome will be the change in pain score on the 0-10 Numeric Rating Scale at 1 month after the procedure.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Chemical Neurolysis | Experimental | Procedure: Chemical NeurolysisParticipant will undergo chemical neurolysis using the study specified neurolytic agent for management of chronic pain. the intervention will be administered according to study protocol, with participant followed prospectively for pain relief and treatment related outcomes |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Age ≥ 18 years. Confirmed diagnosis of pancreatic, gastric, or hepatobiliary malignancy with epigastric/upper abdominal pain.
- Baseline NRS ≥ 7 despite optimized pharmacotherapy, or intolerable opioid side effects.
- ≥ 50% pain relief on diagnostic splanchnic nerve block. Able to provide informed consent.
Key exclusion criteria (2 listed)
- Coagulopathy (INR > 1.5, platelets < 50,000/µL). Local or systemic infection. Uncontrolled hypotension or severe cardiopulmonary compromise precluding prone positioning.
- Intestinal obstruction. Known allergy to contrast, local anesthetic, or the neurolytic agent. Patient refusal.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Chemical NeurolysisChemical neurolysis will be performed using the study-specified neurolytic agent (alcohol or phenol) to provide pain relief in patients with chronic pain. The procedure will be performed under appropriate clinical and imaging guidance according to the study protocol. Participants will be followed prospectively to assess pain relief, duration of analgesia, functional outcomes, and procedure-related adverse events | Procedure or surgery | Chemical Neurolysis |
Primary outcome
Change in pain intensity
Time frame: Baseline to 1 month after the procedure
Pain intensity will be assessed using the 0-10 Numeric Rating Scale (NRS), where 0 represents no pain and 10 represents the worst imaginable pain. The change in NRS pain score from baseline will be assessed following fluoroscopy-guided transdiscal splanchnic nerve neurolysis.
3 secondary outcomes
Change in quality of life
Time frame: Baseline, 1 month, 3 months, and 6 months
Technical success of neurolysis
Time frame: During the procedure
Opioid consumption
Time frame: Baseline, 1 week, 1 month,
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Sep 2026.
- Background: PubMed 17947786von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007 Oct 20;335(7624):806-8. doi: 10.1136/bmj.39335.541782.AD.
- Background: PubMed 8433390Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993 Mar 3;85(5):365-76. doi: 10.1093/jnci/85.5.365.
- Background: PubMed 38343676Goyal S, Kumar A, Goyal D, Attar P, Bhandari B, Purohit G, Mahiswar AP, Gupta S. Efficacy of splanchnic nerve neurolysis in the management of upper abdominal cancer pain: A systematic review and meta-analysis. Indian J Anaesth. 2023 Dec;67(12):1036-1050. doi: 10.4103/ija.ija_439_23. Epub 2023 Dec 13.
- Background: PubMed 40988238Luo L, Cao X, Qiu M, Zhu M, Yan Y, Zhang D, Zhang X. Splanchnic nerve block via transdiscal and paraspinal approach in the treatment of pain in advanced pancreatic cancer: A randomized controlled trial. Medicine (Baltimore). 2025 Sep 19;104(38):e44250. doi: 10.1097/MD.0000000000044250.
- Background: PubMed 36169799Yanaizumi R, Nagamine Y, Harada S, Kuramochi T, Ota S, Abe Y, Nakagawa M, Kamijima K, Hayashi M, Tazawa T, Ogawa K, Goto T. Efficacy and Safety of Neurolytic Splanchnic Nerve Block via Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study. Pain Ther. 2022 Dec;11(4):1359-1372. doi: 10.1007/s40122-022-00432-7. Epub 2022 Sep 28.
- Background: PubMed 35354683Cai Z, Zhou X, Wang M, Kang J, Zhang M, Zhou H. Splanchnic nerve neurolysis via the transdiscal approach under fluoroscopic guidance: a retrospective study. Korean J Pain. 2022 Apr 1;35(2):202-208. doi: 10.3344/kjp.2022.35.2.202.
- Background: PubMed 24156008Kong YG, Shin JW, Leem JG, Suh JH. Computed Tomography (CT) Simulated Fluoroscopy-Guided Transdiscal Approach in Transcrural Celiac Plexus Block. Korean J Pain. 2013 Oct;26(4):396-400. doi: 10.3344/kjp.2013.26.4.396. Epub 2013 Oct 2.
- Background: PubMed 14617407Plancarte-Sanchez R, Mayer-Rivera F, del Rocio Guillen Nunez M, Guajardo-Rosas J, Acosta-Quiroz CO. [Transdiscal percutaneous approach of splanchnic nerves]. Cir Cir. 2003 May-Jun;71(3):192-203. Spanish.
- Background: PubMed 34398950Dong D, Zhao M, Zhang J, Huang M, Wang Y, Qi L, Wan CF, Yu X, Song T. Neurolytic Splanchnic Nerve Block and Pain Relief, Survival, and Quality of Life in Unresectable Pancreatic Cancer: A Randomized Controlled Trial. Anesthesiology. 2021 Oct 1;135(4):686-698. doi: 10.1097/ALN.0000000000003936.
- Background: PubMed 25589943Shwita AH, Amr YM, Okab MI. Comparative Study of the Effects of the Retrocrural Celiac Plexus Block Versus Splanchnic Nerve Block, C-arm Guided, for Upper Gastrointestinal Tract Tumors on Pain Relief and the Quality of Life at a Six-month Follow Up. Korean J Pain. 2015 Jan;28(1):22-31. doi: 10.3344/kjp.2015.28.1.22. Epub 2015 Jan 2.
- Background: PubMed 23682788Zhong W, Yu Z, Zeng JX, Lin Y, Yu T, Min XH, Yuan YH, Chen QK. Celiac plexus block for treatment of pain associated with pancreatic cancer: a meta-analysis. Pain Pract. 2014 Jan;14(1):43-51. doi: 10.1111/papr.12083. Epub 2013 May 20.
- Background2. International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today-Pakistan. GLOBOCAN 2022. Lyon, France: IARC; 2024
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Chemical Neurolysis in people with Upper Abdominal Cancer Pain and Pancreatic Cancer, run by Sahiwal medical college sahiwal at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 17 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Umer Hussain, MBBS (923116467002, mumerhussain775@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in pain intensity (time frame: Baseline to 1 month after the procedure). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07825870, which also lists 13 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Sep 2026.