The Brain Metabolic Change in Chronic Cancer Pain Patient: FDG PET Image Study

Cancer pain deteriorated in quality of life and related with numerous psychosocial problems. Over the one third of cancer patient suffered from moderate to severe cancer pain, even under adequate pain management.

The 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images can provide quantitative results in clinical oncology. As a functional neuroimaging, the PET evidently provided anatomical activated regions, size, and spatial extent information. In this study, we use FDG-PET to investigate changes concerning the glucose metabolism in the brain with or without cancer pain. Therefore, we may provide useful information to treatment target in cancer pain patients.

Study Overview

• Status: Recruiting
• Conditions: Cancer Pain
• Intervention / Treatment: Diagnostic test: FDG PET

Detailed Description

Overall, cancer incidence has decreased and the rate of cancer deaths in both men and women has also significantly declined among both men and women in all site.However, the prevalence of chronic pain is 28.2%, ranging from 22.5% to 35.4%, depending on the location of the primary tumor, and neuropathic characteristics were observed in 19.9% of patients with chronic cancer pain.

Despite numerous studies on cancer pathogenesis and diagnosis, few reports have demonstrated the brain mechanism underlying cancer pain. One study used resting functional magnetic resonance imaging (fMRI) to identify the changes in the functional brain network of chronic bone cancer pain mice under anesthesia. Cancer-induced bone pain (CIBP) might alter resting state activity of the cingulate cortex, prefrontal cortex (PFC) and ventral striatum, indicating a strong affective component of the CIBP mice.In imaging studies of human patients with cancer, patients with chronic cancer pain exhibited activation in the PFC.

The 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images can provide quantitative results in clinical oncology.Owing to the higher glucose metabolic rate in the brain, brain FDG-PET images are not routinely used in the clinical setting. However, several studies have demonstrated functional brain changes in human pain condition.In this study, we use FDG-PET to investigate changes concerning the glucose metabolism in the brain with or without cancer pain.

• Study Type: Observational
• Enrollment (Anticipated): 120

Contacts and Locations

• Study Contact: Name: Wen-ying Lin; Phone Number: +886972652006; Email: ying434@gmail.com

Study Locations

• Taiwan
  • Taipei City, Taiwan, 100
    • Recruiting
    • National Taiwan University Hosipital
    • Contact: Wen-ying Lin; Phone Number: 0972652006; Email: ying434@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Sixty patients in each group of head and neck and esophageal cancer patients. Each cancer group include without cancer pain=30, with cancer pain=30.

Description

Inclusion Criteria:

1. Cancer patients who scheduled whole body FDG-PET image scan for clinically indicated.
2. Age > 20

Exclusion Criteria:

1. Unable to complete questionnaires.
2. Prior evidence of brain metastases.

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
with cancer pain; head and neck and esophageal cancer patients. with cancer pain	Diagnostic test: FDG PET; Cancer patients who scheduled whole body FDG-PET image scan for clinically indicated.
without cancer pain; head and neck and esophageal cancer patients. without cancer pain=30	Diagnostic test: FDG PET; Cancer patients who scheduled whole body FDG-PET image scan for clinically indicated.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Brain metabolism change	The FDG-PET of Standardized uptake values (SUVs) were calculated for each voxel in the reconstructed images to investigate changes concerning the glucose metabolism in the brain with or without cancer pain	12 months

Collaborators and Investigators

• Sponsor: National Taiwan University Hospital

Study record dates

Study Major Dates

• Study Start (Actual): March 2, 2020
• Primary Completion (Actual): March 28, 2022
• Study Completion (Anticipated): December 29, 2022

Study Registration Dates

• First Submitted: February 3, 2020
• First Submitted That Met QC Criteria: February 3, 2020
• First Posted (Actual): February 5, 2020

Study Record Updates

• Last Update Posted (Actual): September 21, 2022
• Last Update Submitted That Met QC Criteria: September 19, 2022
• Last Verified: January 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Cancer Pain
• Other Study ID Numbers: 201911071RINC

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Sharing Supporting Information Type: Study Protocol

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No