Ganglion Impar Neurolysis for Radiation-Induced Pain During Anal Cancer Treatment

Summary

This clinical trial studies how well ganglion impar neurolysis works to improve radiation-induced pain during the treatment of anal or perianal skin cancer that has not spread to other parts of the body (localized). Treatment for anal or perianal skin cancer includes giving chemotherapy and radiation therapy (CRT) at the same time. CRT is frequently associated with several side effects, including radiation-induced pain. Despite advances in radiation therapy delivery, patients may still experience side effects which can lead to treatment breaks or treatment discontinuation. Ganglion impar neurolysis is a type of nerve block procedure in which medicine is injected directly into or around a nerve to block pain. The location of the procedure is near the tail bone and the medicine numbs the nerves that are in charge of sensation in the skin by the buttocks and genitalia. This may improve radiation-induced pain in patients receiving CRT for localized anal or perianal skin cancer.

Detailed description

PRIMARY OBJECTIVE: I. To evaluate the feasibility of ganglion impar neurolysis on decreasing pain in patients undergoing definitive CRT for anal cancer defined as decreasing unscheduled treatment breaks to a median of ≤ 3 days. SECONDARY OBJECTIVE: I. To track toxicities and patient-reported outcomes (PRO) during treatment including intervention of ganglion impar neurolysis. OUTLINE: Patients undergo ganglion impar neurolysis with fluoroscopy during week 4 of CRT on study. After completion of study intervention, patients are followed up during the last week of radiation therapy and at 3-6 months post-treatment.

Arms & interventions

• OtherElectronic Health Record Review

  Ancillary studies

• ProcedureFluoroscopy

  Undergo fluoroscopy

• ProcedureGanglion Impar Neurolysis

  Undergo ganglion impar neurolysis

• OtherQuestionnaire Administration

  Ancillary studies

Outcome measures

Eligibility criteria