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Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot Experience

Background and Importance. Treatment of spinal column metastatic tumors is challenging, especially in the setting of progressive disease despite previous radiation and chemotherapy. Intra-arterial chemotherapy is an uncommonly used but established treatment for head and neck cancers, retinoblastoma,...

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Autor principal: Chopko, Bohdan W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055045/
https://www.ncbi.nlm.nih.gov/pubmed/24963303
http://dx.doi.org/10.1155/2014/915904
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author Chopko, Bohdan W.
author_facet Chopko, Bohdan W.
author_sort Chopko, Bohdan W.
collection PubMed
description Background and Importance. Treatment of spinal column metastatic tumors is challenging, especially in the setting of progressive disease despite previous radiation and chemotherapy. Intra-arterial chemotherapy is an uncommonly used but established treatment for head and neck cancers, retinoblastoma, and glioblastoma. The author reports extension of the IAC concept to vertebral metastatic tumors. Clinical Presentation. Two patients with intractable spinal pain secondary to spinal metastatic involvement at T11-L1 segments were treated with intra-arterial injections of cisplatin, with simultaneous sodium thiosulfate chelation. The first patient, a 60-year old female with metastatic lung carcinoma underwent, three cycles of therapy over a 9-week period; the treated regions demonstrated bone remodeling and sclerosis. The second case was a 40-year old male with malignant pheochromocytoma, who underwent a single treatment and succumbed 5 weeks later from progressive widespread disease. Both patients reported significant pain relief and neither of them exhibited a decline in neurologic function. Conclusion. The intra-arterial delivery of cisplatin appeared to be well tolerated in the two cases. In the case with the longest survival, the treated vertebral segments became more sclerotic, consistent with biomechanical stabilization. Endovascular treatment of spinal metastases may hold promise, especially as newer categories of biologic agents become more widely available.
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spelling pubmed-40550452014-06-24 Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot Experience Chopko, Bohdan W. Case Rep Med Case Report Background and Importance. Treatment of spinal column metastatic tumors is challenging, especially in the setting of progressive disease despite previous radiation and chemotherapy. Intra-arterial chemotherapy is an uncommonly used but established treatment for head and neck cancers, retinoblastoma, and glioblastoma. The author reports extension of the IAC concept to vertebral metastatic tumors. Clinical Presentation. Two patients with intractable spinal pain secondary to spinal metastatic involvement at T11-L1 segments were treated with intra-arterial injections of cisplatin, with simultaneous sodium thiosulfate chelation. The first patient, a 60-year old female with metastatic lung carcinoma underwent, three cycles of therapy over a 9-week period; the treated regions demonstrated bone remodeling and sclerosis. The second case was a 40-year old male with malignant pheochromocytoma, who underwent a single treatment and succumbed 5 weeks later from progressive widespread disease. Both patients reported significant pain relief and neither of them exhibited a decline in neurologic function. Conclusion. The intra-arterial delivery of cisplatin appeared to be well tolerated in the two cases. In the case with the longest survival, the treated vertebral segments became more sclerotic, consistent with biomechanical stabilization. Endovascular treatment of spinal metastases may hold promise, especially as newer categories of biologic agents become more widely available. Hindawi Publishing Corporation 2014 2014-05-22 /pmc/articles/PMC4055045/ /pubmed/24963303 http://dx.doi.org/10.1155/2014/915904 Text en Copyright © 2014 Bohdan W. Chopko. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Chopko, Bohdan W.
Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot Experience
title Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot Experience
title_full Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot Experience
title_fullStr Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot Experience
title_full_unstemmed Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot Experience
title_short Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot Experience
title_sort endovascular treatment of vertebral column metastases using intra-arterial cisplatin: pilot experience
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055045/
https://www.ncbi.nlm.nih.gov/pubmed/24963303
http://dx.doi.org/10.1155/2014/915904
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