EUS-Coeliac Plexus Block Versus Radiofrequency Ablation in Pain Relief of Patients With Malignancy

Study Purpose

Many cancer patients suffer from intractable pain and which is often suboptimally controlled by even strong opioid analgesics. Coeliac plexus neurolysis (CPN) is procedure which intended to permanently destroy the nociceptive pathway that transmits the pain caused by the tumour. It can be with different approaches, such as percutaneously guided by fluoroscopy, echo-endoscopically or surgically with endoscopic approach being the more popular one in many centers equipped with echo-endoscopic services. The effect of CPN has been well established by some retrospective series. The overall response rate to CPN ranges from 70-90%, however, the analgesic effect is limited and up to roughly around 3 months. It is believed that the short-lasting analgesic effect is related to incomplete neurolysis by absolute alcohol injection. Recently, radiofrequency ablation (RFA) of coeliac plexus has been introduced as another mode of CPN. So far, only one small single center randomized controlled trial (RCT) suggesting superior performance in favour to CPN using RFA. This result has to be validated and by a RCT with larger sample size. In addition, data concerning the quality of life (QOL) improvement and cost-effectiveness need to be further elucidated. Therefore, the aim of this study is to perform a RCT to look into these issues.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.

An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.

Searching Both is inclusive of interventional and observational studies.

Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Age ≥18 year-old.
  • - Patients who give informed consent to the study.
  • - Suboptimal pain control with regular analgesics.
  • - Inoperable cancer of pancreas.

Exclusion Criteria:

  • - Patients who refuse to give consent.
  • - Patients aged <18 years.
  • - EUS not possible due to: Problem related to scope insertion such as trismus, stenosis of the upper GI tract Coagulopathy with INR >1.5 or platelet count < 70.
- Low oxygen saturation or extreme blood pressure render endoscopic procedure unsafe

Trial Details

Trial ID:

This trial id was obtained from, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.


Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 4
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

The University of Hong Kong
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Ka Wing Ma, MBBS, MS
Principal Investigator Affiliation The University of Hong Kong
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Overall Status Recruiting
Countries Hong Kong

The disease, disorder, syndrome, illness, or injury that is being studied.

Cancer of Pancreas, Pancreatic Neoplasms, Pain, Cancer-Associated Pain, Pain Management
Additional Details

The aim of this study is to compare the efficacy of EUS-guided CPN versus radiofrequency ablation in patients with pain related to pancreatic cancer. By performing a randomized controlled trial, the clinical outcomes and cost-effectiveness of this new RFA treatment approach can be evaluated.

Arms & Interventions


Active Comparator: EUS-CPB

Chemical ablation of the coeliac plexus

Active Comparator: EUS-CPA

Radiofrequency ablation of the coeliac plexus


Drug: - 98% dehydrated alcohol

coeliac plexus is identified and punctured Injection of 10 mL of .25% bupivacaine, followed by 10 mL of 98% dehydrated alcohol.

Device: - 19G EUSRA needle, Taewoong Medical, Korea

10W-30W RFA will be applied unilaterally or bilaterally depends on individual anatomical characteristics for 10-50s Complete ablation of coeliac plexus nervous tissue is confirmed by appearance of air-bubble ultrasound scan

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

International Sites

Queen Mary Hospital, Hong Kong, Hong Kong




Queen Mary Hospital

Hong Kong, , 000000

Site Contact

Wan Yee Chiu, BISC

+852 2255 4848

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