Oxycodone combined with pulsed radiofrequency for refractory cancer pain from spinal metastases: a randomized controlled study
In brief
Adding pulsed radiofrequency halves opioid dose escalation in spinal metastasis pain
In a small randomized trial of 60 patients, those receiving oxycodone plus pulsed radiofrequency reported lower pain scores, fewer breakthrough episodes, and a reduced opioid escalation rate (46% vs 73%) compared with oxycodone alone. The combo also preserved T-cell counts, improved quality of life, and lowered overall side effects, but larger studies are needed to confirm these findings.
- Journal
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Q1)
- Published
- 24 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- L Li, Hj Wang, Xj Wang, Sc Xing, Jh Zhong
- PMID
- 42635821
- DOI
- 10.1007/s00520-026-11122-x
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (paper of the day, 25 August 2026): Oxycodone + PRF improves refractory cancer pain
Abstract
OBJECTIVES: To assess the clinical efficacy and safety of oxycodone combined with pulsed radiofrequency (PRF) in the treatment of refractory cancer pain (RCP) arising from spinal metastasis. METHODS: A randomized controlled trial enrolled 60 patients with RCP due to spinal metastases. Participants were randomly allocated to the oxycodone alone group (Group A, n = 30) or the oxycodone combined with PRF group (Group B, n = 30). Primary outcomes comprised pain scores on the Numerical Rating Scale (NRS) and episodes of breakthrough pain at post-treatment time points Secondary endpoints included opioid consumption, immune parameters, quality of life, and adverse event incidence. RESULTS: Group B had significantly lower NRS scores and fewer 24-h breakthrough pain episodes than Group A at post-treatment time points (p < 0.05). The opioid consumption and 7/30-day drug escalation indices of Group B were significantly lower (p < 0.05), with a lower dose escalation rate (46.67% vs. 73.33%, p = 0.035). Group B exhibited relatively better preserved selected T lymphocyte subset parameters (CD3⁺, CD4⁺ T cell percentages, CD4⁺/CD8⁺ ratio) and quality of life scores (p < 0.05), with a markedly lower overall adverse reaction rate (43.33% vs. 70.00%, p = 0.037) and no serious adverse events observed. CONCLUSIONS: This exploratory pilot randomized controlled trial indicated that the combination of oxycodone and PRF may contribute to improved pain control, decreased opioid consumption, and attenuated decline in lymphocyte subsets alongside enhanced quality of life in patients with spinal metastasis-related refractory cancer pain. No serious adverse events were documented. The clinical and oncological significance of the observed intergroup differences in T cell indices remains unclear. These preliminary observations require verification in larger prospective trials.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.