Continuous intrathecal therapy for refractory cancer pain: A systematic review and meta-analysis focusing on partially implanted devices

Conventional pain therapies sometimes fail in patients with severe neuropathic pain or bone metastases. Intrathecal therapy provides an alternative but is resource-intensive, technically demanding and costly.

To compare the advantages and limitations of partially implanted devices (PIDs) versus conventional medical management or totally implanted devices (TIDs) in adults with cancer-related pain.

A systematic literature review up to September 2024 was conducted, with an updated search performed in August 2026. Eligible studies included those on adults with refractory cancer pain receiving PID intrathecal therapy compared with conventional therapy, and comparative studies evaluating PIDs versus TIDs. Pain intensity was analysed using a meta-analysis; a synthesis without meta-analysis was used for other outcomes.