title: Modification of loco-regional microenvironment in brain tumors by spinal cord stimulation. Implications for radio-chemotherapy.
abstract: The effectiveness of radiotherapy and chemotherapy in high grade gliomas (HGG) depends on tumor micro-environment. We summarize our experience of the influence of spinal cord stimulation (SCS) on this micro-environment. Patients with HGG (n = 26) were assessed pre- and post-SCS, using: (1) Doppler in middle cerebral arteries (MCA) and (2) in common carotid arteries (CCA); (3) tumor blood-flow using single photon emission computed tomography (SPECT); (4) tumor-pO(2) (mmHg) using polarographic probes (eight tumor areas from five patients); and (5) tumor glucose metabolism using (18)F-fluoro-2-deoxyglucose ((18)FDG) positron emission tomography ((18)FDG-PET). Pre-SCS: tumor blood-flow was lower (P < 0.001) than peri-tumor areas and healthy contra-lateral areas. Tumor-pO(2) was lower (P < 0.042) than healthy tissue. Tumor glucose metabolism was higher than peri-tumor areas (P = 0.017) and healthy contra-lateral areas (P = 0.048). Post-SCS: there were increases in: MCA blood-flow (P ≤ 0.002), CCA blood-flow (P ≤ 0.013), tumor blood-flow (P = 0.033), tumor glucose metabolism (P = 0.027) and tumor-pO(2) (P = 0.022). The percentage of hypoxic values decreased (P = 0.007). SCS can modify tumor micro-environment. The potential usefulness of SCS in improving the effectiveness of radio-chemotherapy in HGG needs to be evaluated.
authors: Department of Radiation Oncology & Research Unit, Dr. Negrin University Hospital, C/Barranco la Ballena s/n, 35020 Las Palmas, Spain. bernardinoclavo@terra.es
authors: B
authors: B
authors: Clavo
authors: F
authors: F
authors: Robaina
authors: B
authors: B
authors: Valcarcel
authors: L
authors: L
authors: Catala
authors: J L
authors: JL
authors: Perez
authors: A
authors: A
authors: Cabezon
authors: I J
authors: IJ
authors: Jorge
authors: D
authors: D
authors: Fiuza
authors: M A
authors: MA
authors: Hernandez
authors: R
authors: R
authors: Jover
authors: J L
authors: JL
authors: Carreras
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D004558:Electric Stimulation; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000502:physiology; D019635:Neurosurgical Procedures; D010101:Oxygen Consumption; D011048:Polarography; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013116:Spinal Cord / Q000502:physiology*; D015899:Tomography, Emission-Computed, Single-Photon; D017585:Ultrasonography, Doppler, Transcranial; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18