Effectiveness of methadone and intrathecal analgesia for intractable cancer pain in pediatric patients with malignant tumors: a case report

Abstract

We report the role of methadone and intrathecal analgesia in successfully treating intractable cancer pain associated with a malignant tumor in a pediatric patient. Case: A 12-year-old girl presented with a history of a malignant peripheral nerve sheath tumor when she was 3 years old. At 12 years of age in June 2016, she developed paraplegic symptoms secondary to thoracic cord infiltration. Pain worsened and was refractory to oxycodone. In October of the same year, she was transferred to the palliative care ward of our hospital. Oxycodone was switched to methadone, which led to pain relief by the 7th day of hospitalization. On the 33rd of hospitalization, achalasia worsened with disease progression, and intrathecal analgesia was initiated. Pain was well controlled until her death. To date, the concomitant use of methadone and intrathecal analgesia has not been reported in Japan. We report the use of this combination for safe and effective management of intractable cancer pain in pediatric patients.