80% of palliative care cancer patients suffer from severe pain. The management of these pain
improves the quality of life of these patients. The management of opioid pain refractory to
date remains a difficulty for caregivers. Hypophysectomy performed to try to control
hormone-dependent neoplasia also help relieve pain associated with lesions secondary cancer.
The surgical hypophysialis radio Gamma Knife ® was recently performed on a small number of
patients. She would have the advantage of reducing the risk of complications compared to
other techniques and achieve similar analgesic effect on diffuse, or mixed nociceptive pain
associated with metastases on average in 2 days and would reduce or stop opiates most often
responsible for side effects impairing the quality of life. The objective of this clinical
trial, multicenter, prospective, randomized controlled is to evaluate the effectiveness of
surgical hypophysialis radio for patients in palliative situations with refractory cancer
pain in opioid level III. The type of pain "cancer pain" was done in order to optimize the
recruitment and homogenization of the study population: patients cared for in palliative care
units are mostly patients cancer (70-80%). This study is therefore part of a palliative
setting and the results of this test can be extrapolated to other populations of palliative
patients with refractory pain.