Electrochemotherapy in radiotherapy-resistant epidural spinal cord compression in metastatic cancer patients

被引：16

作者：

Deschamps, Frederic ^{[1
,2
]}

Tselikas, Lambros ^{[1
]}

Yevich, Steven ^{[1
]}

Bonnet, Baptiste ^{[1
]}

Roux, Charles ^{[1
]}

Kobe, Adrian ^{[1
]}

Besse, Benjamin ^{[3
]}

Berthelot, Kevin ^{[4
]}

Gaudin, Amelie ^{[5
]}

Mir, Lluis M. ^{[2
]}

de Baere, Thierry

Compression, Cord

机构：

[1] Univ Paris Saclay, Gustave Roussy, Dept Intervent Radiol, 114 rue Edouard Vaillant, F-94805 Villejuif, France

[2] Univ Paris Saclay, CNRS, Gustave Roussy, Aspects Metab & Syst oncogenese nouvelles approche, F-94805 Villejuif, France

[3] Univ Paris Saclay, Gustave Roussy, Int Ctr Thorac Canc CICT, Dept Med Oncol, 114 rue Edouard Vaillant, F-94805 Villejuif, France

[4] Univ Paris Saclay, Gustave Roussy, Dept Radiotherapy, 114 rue Edouard Vaillant, F-94805 Villejuif, France

[5] Univ Paris Saclay, Gustave Roussy, Dept Pharmacol, 114 rue Edouard Vaillant, F-94805 Villejuif, France

来源：

EUROPEAN JOURNAL OF CANCER | 2023年 / 186卷

关键词：

Electrochemotherapy; Therapy; Palliative; Metastasis; Spinal column; Paralysis; Radiology; Bone; Extramedullary Spinal; Cord Compression; IRREVERSIBLE ELECTROPORATION; BLEOMYCIN; ABLATION; NUMBER;

D O I：

10.1016/j.ejca.2023.03.012

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective: To report efficacy and safety of percutaneous electrochemotherapy (ECT) in patients with radiotherapy-resistant metastatic epidural spinal cord compression (MESCC).Material/ methods: This retrospective study analyzed all consecutive patients treated with bleomycin-based ECT between February-2020 and September-2022 in a single tertiary referral cancer center. Changes in pain were evaluated with the Numerical Rating Score (NRS), in neurological deficit with the Neurological Deficit Scale, and changes in epidural spinal cord compression were evaluated with the epidural spinal cord compression scale (ESCCS) using an MRI.Results: Forty consecutive solid tumour patients with previously radiated MESCC and no effective systemic treatment options were eligible. With a median follow-up of 5.1 months [1-19.1], toxicities were temporary acute radicular pain (25%), prolonged radicular hypoesthesia (10%), and paraplegia (7.5%). At 1 month, pain was significantly improved over baseline (median NRS: 1.0 [0-8] versus 7.0 [1.0-10], P < .001) and neurological benefits were considered as marked (28%), moderate (28%), stable (38%), or worse (8%). Three-month follow-up (21 patients) confirmed improved over baseline (median NRS: 2.0 [0-8] versus 6.0 [1.0-10], P < .001) and neurological benefits were considered as marked (38%), moderate (19%), stable (33.5%), and worse (9.5%). One-month post-treatment MRI (35 patients) demonstrated complete response in 46% of patients by ESCCS, partial response in 31%, stable disease in 23%, and no patients with progressive disease. Three-month post-treatment MRI (21 patients) demonstrated complete response in 28.5%, partial response in 38%, stable disease in 24%, and progressive disease in 9.5%.Conclusions: This study provides the first evidence that ECT can rescue radiotherapy-re (c) 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC (c) 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

引用

页码：62 / 68

页数：7

共 22 条

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