1. Effect of cervical spinal cord stimulation on regional blood flow and oxygenation in advanced head and neck tumours.
- Author
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Clavo B, Robaina F, Catalá L, Pérez JL, Lloret M, Caramés MA, Morera J, López L, Suárez G, Macías D, Rivero J, and Hernández MA
- Subjects
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cervical Vertebrae, Combined Modality Therapy, Female, Head and Neck Neoplasms drug therapy, Head and Neck Neoplasms radiotherapy, Humans, Male, Middle Aged, Prospective Studies, Regional Blood Flow, Carotid Artery, Common, Electric Stimulation Therapy, Head and Neck Neoplasms blood supply, Head and Neck Neoplasms physiopathology, Ischemia physiopathology, Oxygen analysis, Spinal Cord physiology
- Abstract
Background: Tumour ischaemia leads to decreased delivery of oxygen, chemotherapy and radiosensitisers. Hypoxia in head and neck (H&N) tumours is an important adverse prognostic factor. Spinal cord stimulation (SCS) is a well-established neurosurgical technique in the treatment of several ischaemic syndromes. This prospective study evaluated the effect of cervical-SCS on common carotid artery (CCA) blood flow and tumour oxygenation in patients with advanced H&N cancer., Patients and Methods: Sixteen patients with advanced H&N tumours were enrolled. Cervical-SCS devices were inserted subcutaneously prior to commencement of scheduled chemoradiotherapy. Pre- and post-SCS measurements were as follows: (i) tumour oxygenation (mmHg) using polarographic probes; (ii) blood flow quantification (ml/min) and diastolic and systolic velocimetry (cm/s) in the CCA using colour Doppler., Results: After SCS, median tumour oxygenation increased in two-thirds of patients (34%; P = 0.023), all patients had improved CCA blood flow (50%; P <0.001) and almost all patients showed an increased CCA diastolic velocity (26%; P = 0.003) and systolic velocity (20%; P = 0.011)., Conclusions: Cervical-SCS increased tumour oxygenation and CCA blood flow, and could enhance the loco-regional delivery of oxygen, radiosensitising and chemotherapeutic drugs. Cervical-SCS as adjuvant in chemoradiotherapy of these tumours warrants further investigation.
- Published
- 2004
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