EP075 Does intrathecal pump therapy reduce systemic morphine equivalent daily dose in patients with chronic cancer pain? A single centre retrospective analysis
Bibliographic record
Abstract
Background and Aims Chronic pain is a prevalent and therapeutically challenging symptom in cancer patients, often limited by intolerable side effects or inadequate response to conventional pain management strategies. Intrathecal drug delivery offers a targeted approach to pain management, potentially reducing systemic opioid requirements and associated side effects. There is a paucity of literature examining the efficacy of intrathecal pump (ITP) therapy in decreasing systemic opioid use. This retrospective review aims to assess the potential impact of ITP therapy on Morphine Equivalent Daily Dose (MEDD) in cancer patients with chronic pain. Methods A retrospective review was conducted on cancer patients at St. Paul’s Hospital in British Columbia, Canada, who received ITP therapy for chronic pain management between June 2022 and March 2024. Data regarding opioid use—including oral, subcutaneous, transdermal, and parenteral routes—were collected through chart review both prior to and approximately six months following ITP implantation. These opioid dosages were standardized and converted to oral Morphine Equivalent Daily Dose (MEDD). The primary analytical focus was on median MEDD, with the main outcome measure being the percent reduction in MEDD following therapy. Results A total of 18 patients received ITP therapy during the review time frame. 11 patients were included in the final analysis with 7 patients being excluded due to mortality prior to the 6-month postoperative time point or incomplete data. Raw data analysis revealed a significant reduction in MEDD following ITP therapy. The pre-implant median MEDD was 868.4 mg compared to 503.9 mg 6 months post-operatively, showing a 42% reduction in MEDD. 11% (2/18) of patients discontinued systemic opioids completely. Conclusions ITP therapy has the potential to improve chronic cancer pain and reduce systemic opioid requirements. These findings support the need for further research to evaluate the efficacy of ITP therapy in improving pain control and reducing systemic opioid requirements among diverse oncological patient populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".