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Annals of Oncology 15:802-807, 2004
© 2004 European Society for Medical Oncology

Original Paper

Effect of cervical spinal cord stimulation on regional blood flow and oxygenation in advanced head and neck tumours

Received 23 September 2003; revised 12 December 2003; accepted 22 January 2004

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.

B. Clavo1,6,*, F. Robaina2,6, L. Catalá3,6, J. L. Pérez4,6, M. Lloret1,6, M. Á. Caramés2, J. Morera2,6, L. López1,6, G. Suárez1,6, D. Macías4,6, J. Rivero5 and M. A. Hernández1,6

Departments of 1 Radiation Oncology Research Unit, 2 Functional and Stereotactic Neurosurgery and Chronic Pain Unit, 3 Radiology, 4 Medical Physics and 5 Otolaryngology, Dr Negrín Hospital, Las Palmas; 6 Canary Islands Institute for Cancer Research (ICIC), Las Palmas, Spain

Key words: blood flow, colour Doppler, head & neck cancer, spinal cord stimulation, transcranial Doppler, tumour oxygenation


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