Increase of brain tumor oxygenation during cervical spinal cord stimulation. Report of three cases.
Malignant brain tumors have been shown to decrease O2 and blood flow resulting in hypoxia and low perfusion that in turn reduce radiation sensitivity and access by chemotherapeutic agents. Spinal cord stimulation (SCS) is a procedure that has been used quite successfully in the treatment of pain and ischemic syndromes. In the present study the authors applied the method and, with polarographic probes inserted in the tumor sites, measured the changes in tissue oxygenation and hypoxia in two separate tumor areas in three patients with high-grade astrocytomas. The results of the SCS indicated that overall tumor oxygenation increased by 90% (from 13.2+/-9.4 mm Hg to 25.1+/-9.6 mm Hg; p = 0.013); the percentage of moderately hypoxic values (< 10 mm Hg) decreased by 55% (from 48.6+/-20.1% to 22+/-13.3%; p = 0.026); and the percentage of considerably hypoxic values (< 5 mm Hg) decreased by 45% (from 28+/-20.3% to 15.5+/-15%; p = 0.018). In this report the authors describe a potential novel application of SCS, and the preliminary results suggest that tumor tissue oxygenation and hypoxia are significantly improved as a result. If these findings are confirmed, the method may be applicable as an adjuvant to radiotherapy and chemotherapy regimens.
Clavo
Bernardino
B
Departments of Radiation Oncology and Research Unit, Dr. Negrín Hospital, Las Palmas, Canary Islands, Spain. bernardinoclavo@terra.es
Robaina
Francisco
F
Morera
Jesús
J
Ruiz-Egea
Eugenio
E
Pérez
Juan L
JL
Macías
David
D
Caramés
Miguel A
MA
Catalá
Luis
L
Hernández
M Antonia
MA
Günderoth
Martina
M
D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000098:blood supply* / Q000532:radiotherapy / Q000601:surgery; D001932:Brain Neoplasms / Q000098:blood supply* / Q000532:radiotherapy / Q000601:surgery; D015687:Cell Hypoxia / Q000502:physiology*; D002540:Cerebral Cortex / Q000098:blood supply / Q000528:radiation effects / Q000601:surgery; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005260:Female; D005909:Glioblastoma / Q000098:blood supply* / Q000532:radiotherapy / Q000601:surgery; D005910:Glioma / Q000098:blood supply* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D011048:Polarography; D018714:Radiotherapy, Adjuvant; D012039:Regional Blood Flow / Q000502:physiology; D013116:Spinal Cord / Q000503:physiopathology*