胸椎腫瘍によるがん性痛に対して長期間のくも膜下ベタメタソン投与を行った1例

概要

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We have performed intrathecal injections of betamethasone for uncontrollable cancer pain since 1999. We report on a patient who received repeated such injections because of severs cancer pain. A 70 -year-old man with a 12th thoracic vertebral tumor had intractable lower limb pain with gait-disturbance, despite conventional cancer pain treatments. After informed consent from the patient and his wife, betamethasone (2-3 mg) combined with saline was injected into the lumber intrathecal space through a 27 G pencil-point needle once a week. As a result, he had long-lasting pain relief and improvement of ADL (activity of daily living) with no adverse effects, such as neurotoxicity caused by glucocorticoid. Pain relief and improvement of his ADL were maintained for 19 months. But, his pain eventually recurred, and his ADL was again disturbed. MRI revealed a tumor-sized development in the T12 vertebra. Despite intrathecal betamethasone injections, his severe pain was not relieved. The intrathecal injection of betamethasone has the possibility of usefulness in treatment of intractable cancer pain, especially in vertebral tumors.
2012-10-25