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        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Generally&#44; high-grade gliomas and head and neck tumors have decreased loco-regional blood flow resulting in reduced delivery of chemotherapy and oxygen&#44; as well as an increases in radiation resistance to radiotherapy&#46; The aim of this study was to analyze the effect of cervical spinal cord electrical stimulation &#40;cSCS&#41; on cerebral blood flow in patients with those tumors&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We have evaluated 27 cancer patients with 12 with high grade gliomas and 15 with advanced head and neck tumors&#44; who had cSCS devices placed after tumor diagnoses and before the commencementinitiating of radio-chemotherapy&#46; They were 12 high grade gliomas and 15 advanced head and neck tumors&#46; Before and after cSCS&#44; cerebral blood flow was assessed bilaterally by transcranial Doppler&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">During cSCS there was a significant &#40;p&#60;0&#46;001&#41; increase in systolic &#40;mean &#62;22&#37;&#41; and diastolic &#40;&#62;29&#37;&#41; blood-flow velocities in both&#44; healthy and tumor middle cerebral arteries&#46; The analyses by subgroup of tumors showed similarly significant outcomesfindings&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The results suggest that neuro-stimulationspinal cord electrical stimulation can increase cerebral blood flow in cancer patients&#46; The implication is that this technique could be useful in modifying locoregional ischemia in brain tumors thus improveing the outcomes of after radio-chemotherapy&#46; Further research is in progress to confirm the advantages of the technique&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los gliomas de alto grado y los tumores avanzados de cabeza y cuello generalmente tienen un flujo sangu&#237;neo disminuido&#46; Esto produce una disminuci&#243;n de la llegada de quimioterapia agentes quimioter&#225;picos y ox&#237;geno&#44; lo que lleva a un aumento de la resistencia a la radioterapia y a la quimioterapia&#46; El objetivo de este estudio fue analizar el efecto de la electroestimulaci&#243;n epidural de la m&#233;dula espinal cervical &#40;EME&#41; sobre el flujo cerebral en pacientes con esos tumores&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Hemos evaluado 27 pacientes oncol&#243;gicos portando dispositivos de EME&#44; que fueron colocados despu&#233;s del diagn&#243;stico y antes de empezar el tratamiento con radio-quimioterapia&#46; Se trata de 12 pacientes con gliomas de alto grado y 15 pacientes con tumores avanzados de cabeza y cuello&#46; Antes y despu&#233;s de la EME se determin&#243; bilateralmente el flujo sangu&#237;neo en las arterias cerebrales medias mediante Doppler transcraneal&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Durante la EME se produjo un aumento significativo &#40;p&#60;0&#46;001&#41; de la velocidad sist&#243;lica &#40;mean media &#8805;22&#37;&#41; y diast&#243;lica &#40;&#8805;29&#37;&#41; del flujo en la arteria cerebral media&#44; tanto del hemisferio ipsilateral al tumor como del hemisferio sano&#46; El an&#225;lisis por subgrupos de tumores mostr&#243; tambi&#233;n resultados semejantes&#46;</p> <span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los resultados sugieren que la EME es capaz de aumentar el flujo sangu&#237;neo cerebral en pacientes oncol&#243;gicos&#46; La principal implicaci&#243;n de este hallazgo ser&#237;a su potencial utilidad para modificar la isquemia local y regional de los tumores cerebrales&#44; y as&#237; intentar mejorar el efecto de la radioterapia y quimioterapia&#46; Est&#225;n en marcha estudios adicionales para confirmar los potenciales efectos beneficiosos de la t&#233;cnica&#46;</p>"
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Vol. 18. Núm. 1.
Páginas 28-32 (enero 2007)
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Vol. 18. Núm. 1.
Páginas 28-32 (enero 2007)
Cerebral blood flow increase in cancer patients by applying cervical spinal cord stimulation
Aumento del flujo cerebral en pacientes con tumores cerebrales y de cabeza y cuello mediante estimulación eléctrica medular cervical
Visitas
1543
B. Clavo, F. Robaina
, L. Catalá, M. Lloret, B. Pinar, M.A. Caramés, A. Ruiz, A. Cabezón, G. González, P. Lara, E. Ruiz-Egea, M.A. Hernández
Dr. Negrín University Hospital. Las Palmas. (Canary Islands) Spain. (Stereotactic and Functional Neurosurgery Unit. Research Unit. Dep. Radiation Oncology. Radiology and Medical Physics) and ICIC (Canary Islands Institute for Cancer Research). Las Palmas. Spain
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Summary
Introduction

Generally, high-grade gliomas and head and neck tumors have decreased loco-regional blood flow resulting in reduced delivery of chemotherapy and oxygen, as well as an increases in radiation resistance to radiotherapy. The aim of this study was to analyze the effect of cervical spinal cord electrical stimulation (cSCS) on cerebral blood flow in patients with those tumors.

Patients and methods

We have evaluated 27 cancer patients with 12 with high grade gliomas and 15 with advanced head and neck tumors, who had cSCS devices placed after tumor diagnoses and before the commencementinitiating of radio-chemotherapy. They were 12 high grade gliomas and 15 advanced head and neck tumors. Before and after cSCS, cerebral blood flow was assessed bilaterally by transcranial Doppler.

Results

During cSCS there was a significant (p<0.001) increase in systolic (mean >22%) and diastolic (>29%) blood-flow velocities in both, healthy and tumor middle cerebral arteries. The analyses by subgroup of tumors showed similarly significant outcomesfindings.

Conclusions

The results suggest that neuro-stimulationspinal cord electrical stimulation can increase cerebral blood flow in cancer patients. The implication is that this technique could be useful in modifying locoregional ischemia in brain tumors thus improveing the outcomes of after radio-chemotherapy. Further research is in progress to confirm the advantages of the technique.

Key words:
Brain tumors
Cerebral blood flow
Ischemia
Spinal cord stimulation
Transcranial Doppler
Abreviaturas:
CBF
cSCS
H&N
MCA
PET
SCS
SPECT
TCD
Resumen
Introducción

Los gliomas de alto grado y los tumores avanzados de cabeza y cuello generalmente tienen un flujo sanguíneo disminuido. Esto produce una disminución de la llegada de quimioterapia agentes quimioterápicos y oxígeno, lo que lleva a un aumento de la resistencia a la radioterapia y a la quimioterapia. El objetivo de este estudio fue analizar el efecto de la electroestimulación epidural de la médula espinal cervical (EME) sobre el flujo cerebral en pacientes con esos tumores.

Material y métodos

Hemos evaluado 27 pacientes oncológicos portando dispositivos de EME, que fueron colocados después del diagnóstico y antes de empezar el tratamiento con radio-quimioterapia. Se trata de 12 pacientes con gliomas de alto grado y 15 pacientes con tumores avanzados de cabeza y cuello. Antes y después de la EME se determinó bilateralmente el flujo sanguíneo en las arterias cerebrales medias mediante Doppler transcraneal.

Resultados

Durante la EME se produjo un aumento significativo (p<0.001) de la velocidad sistólica (mean media ≥22%) y diastólica (≥29%) del flujo en la arteria cerebral media, tanto del hemisferio ipsilateral al tumor como del hemisferio sano. El análisis por subgrupos de tumores mostró también resultados semejantes.

Discusión

Los resultados sugieren que la EME es capaz de aumentar el flujo sanguíneo cerebral en pacientes oncológicos. La principal implicación de este hallazgo sería su potencial utilidad para modificar la isquemia local y regional de los tumores cerebrales, y así intentar mejorar el efecto de la radioterapia y quimioterapia. Están en marcha estudios adicionales para confirmar los potenciales efectos beneficiosos de la técnica.

Palabras clave:
Tumores cerebrales
Flujo cerebral
Isquemia
Estimulación medular
Doppler transcraneal

Artículo

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