Treatment of Opioid-refractory Pain (WHO Level III) by Pituitary Radiosurgery

Inclusion Criteria

• •Man or woman, aged 18 years or older;
• •Subject suffering from nociceptive or mixed pain, not related to acts, refractory to standard opioid therapy
• •Subject having a cancer defined by histology whatever the origin of the primitive cancer,
• •Subject having multiple bone metastases
• •Subject in palliative care state according to the definition given by the French Society of Palliative Care and Support
• •Subject supported by structures of palliative care, pain or cancer involved in the study
• •Inpatient and outpatient
• •Subject without a curative cancer treatment and with or without palliative anticancer treatment;
• •Subject non in "ultimate" phase (estimated survival superior at 48 h by a physician)
• •Subject with acceptable general condition (Karnofsky performance Status Scale superior at 40
• •Subject with a preserved vigilance defined from the Epworth scale
• •Subject with preserved cognition according to the scale Basic Test Concentration, Memory and Guidance (TELECOM)
• •Subject which can fill in a questionnaire, able to read or to understand the French language;
• •Subject who signed an informed consent;
• •Subject affiliated to the French health insurance system.