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

Deschamps, Frédèric; Tselikas, Lambros; Yevich, Steven; Bonnet, Baptiste; Roux, Charles; Kobe, Adrian; Besse, Benjamin; Berthelot, Kevin; Gaudin, Amélie C. M.; Mir, Lluis M.; Baère, Thierry De

doi:10.1016/j.ejca.2023.03.012

Cited by 8 publications

(15 citation statements)

References 21 publications

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“…MRI confirmed the tumor's local response, and a biopsy at 3 months of follow-up showed >95% necrosis of tumor tissue [17]. Recently, Deschamps et al [18] reported the most numerous series of spine metastatic diseases treated with ECT and bleomycin. The authors reported a total of 40 patients with metastatic epidural spinal cord compression.…”

Section: Discussionmentioning

confidence: 93%

“…Recently, ECT has been used in more than 83 centers all over Europe [24], and studies have shown that it can also potentially be used in the treatment of bone tumors and bone metastases. To date, its use in clinical practice as a new option for metastasis management is increasing; however, while several studies have been conducted about this technique in the treatment of bone metastasis, few papers have described its use and results in spine metastases [12,[16][17][18]. In fact, from our systematic review, only four articles described the use of ECT in spine metastases [12,[16][17][18].…”

Section: Discussionmentioning

confidence: 93%

“…After careful screening following the PRISMA flowchart and considering the purpose of this systematic review and the exclusion criteria, only four studies [12,[16][17][18] were retrieved and assessed for eligibility (Figure 1; Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…All patients in this series received radiotherapy, and 12 patients had a previous surgery. ECT was performed with the percutaneous image CT-guided technique, as described by Cornelis [17], with pain relief obtained prevalently in the first month after the procedure and neurological improvement in the third month of follow-up [18]. The study's data analysis revealed that only 21 out of 40 patients were evaluated at the three-month follow-up, which dampens the enthusiasm regarding the described results [18].…”

Section: Discussionmentioning

confidence: 99%

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Electrochemotherapy in Spine Metastases: A Case Series Focused on Technical Aspects, Surgical Strategies and Results

Angelini,

D’Amico,

Paolilli

et al. 2024

Diagnostics

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Metastases are complications of primary tumors due to prolonged cancer survival and have become an important issue for oncological patients and the most frequent cause of death and disability. Bone metastases occur at a later stage of cancer disease, and the spine is the most frequent site. To date, the aim of the treatment of metastases remains to be the control of disease and provide a satisfactory quality of life. The decision making of treatment is influenced by several factors such as the status of the primary disease, the number of metastases, site involvement, and the performance status of the patients. For this reason, the treatment of metastases is challenging and undergoes constant development. Therefore, alternative techniques with respect to surgery, which is the first option but not always practicable, and radiochemotherapy are attractive. Lately, electrochemotherapy has emerged as an innovative method for treating various primary and metastatic solid tumors, showing promising outcomes in terms of inducing tumor tissue necrosis and alleviating symptoms. This technique uses electric pulses to increase the uptake of chemotherapy by tumor cells. Despite the initial enthusiasm and good results in the treatment of bone tumors, relatively few papers have described its use in spine metastases. Therefore, we conducted a systemic review of this intriguing topic while also reporting our experience in the use of electrochemotherapy for the treatment of spine metastases.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Electrochemotherapy in Spine Metastases: A Case Series Focused on Technical Aspects, Surgical Strategies and Results

Angelini,

D’Amico,

Paolilli

et al. 2024

Diagnostics

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“…No serious adverse events related to the electric field applied and no bleomycin toxicity were reported for bone and surrounding tissues [ 43 ]. ECT with bleomycin then came out to be a valuable tool in pain reduction and improving the quality of life in patients affected by other bone metastases [ 16 , 44 ] and vascular malformation [ 15 ]. Osteolytic vertebral metastases may present with cortical expansion, soft tissue masses, and vertebral compression fractures, mimicking aggressive VHs [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Electrochemotherapy in Aggressive Hemangioma of the Spine: A Case Series and Narrative Literature Review

Tedesco,

Noli,

Griffoni

et al. 2024

JCM

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(1) Background: this case series and literature review aims to evaluate the efficacy and safety of electrochemotherapy in the management of aggressive spinal hemangiomas, presenting two distinct cases. (2) Methods: we present two cases of spinal aggressive hemangioma which were refractory to conventional treatments and underwent electrochemotherapy. Case 1 involves a 50-year-old female who presented with an aggressive spinal hemangioma of L1, who previously underwent various treatments including surgery, radio-chemotherapy, and arterial embolization. Case 2 describes a 16-year-old female with a T12 vertebral hemangioma, previously treated with surgery and stabilization, who faced limitations in treatment options due to her young age and the location of the hemangioma. (3) Results: in Case 1, electrochemotherapy with bleomycin was administered following the failure of previous treatments and resulted in the reduction of the lesion size and improvement in clinical symptoms. In Case 2, electrochemotherapy was chosen due to the risks associated with other treatments and was completed without any adverse events. Both cases demonstrated the potential of electrochemotherapy as a viable treatment option for spinal hemangiomas, especially in complex or recurrent cases. (4) Conclusions: electrochemotherapy with bleomycin is a promising treatment for aggressive spinal hemangiomas when conventional therapies are not feasible or have failed. Further research is needed to establish definitive protocols and long-term outcomes of electrochemotherapy in spinal hemangioma management.

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Summary and update on the management of differentiated thyroid cancer in 2023

Raymond,

Klein,

Borson-Chazot

2024

Annales d'Endocrinologie

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

Cited by 8 publications

References 21 publications

Electrochemotherapy in Spine Metastases: A Case Series Focused on Technical Aspects, Surgical Strategies and Results

Electrochemotherapy in Spine Metastases: A Case Series Focused on Technical Aspects, Surgical Strategies and Results

Electrochemotherapy in Aggressive Hemangioma of the Spine: A Case Series and Narrative Literature Review

Summary and update on the management of differentiated thyroid cancer in 2023

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