Electrochemotherapy to metastatic spinal melanoma: A novel treatment of spinal metastasis?

Alessandro Gasbarrini, Wuilker Knoner Campos, Laura Campanacci, Stefano Boriani

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Study Design. Preliminary report of new antitumor treatment. Objective. To evaluate the effectiveness of electrochemotherapy as a novel treatment of spinal metastasis. Summary of Background Data. Electrochemotherapy is a new antitumor treatment that combines systemic bleomycin with electric pulses delivered locally at the tumor site. These electric pulses permeabilize cell membranes in the tissue, allow bleomycin delivery diffusion inside the cells, and increase bleomycin cytotoxicity. Previous clinical studies have demonstrated the effectiveness of electrochemotherapy in the treatment of several primary and metastatic solid tumors. Methods. Treatment planning for electrode positioning and electrical pulse parameters was prepared for 4 needle electrodes. Mini-open surgery with a left L5 laminectomy was performed to introduce the eletrodes. The patient was treated according to the established Electrochemotherapy Protocol with Bleomycin. Clinical efficacy of electrochemotherapy was evaluated according to a visual analog scale of pain, Oswestry Disability Index 2.0, the Karnofsky Performance Scale, and Response Evaluation Criteria in Solid Tumors. Results. The assessed follow-up period was 48 months after the electrochemotherapy procedure. Neither serious electrochemotherapy- related adverse events, nor bleomycin toxicity were reported. Overall improvement in pain according to Oswestry Disability Index 2.0 and Karnofsky Performance Scale outcomes was better. Conclusion. Our case represents, to our knowledge, the first one to test the potential role of electrochemotherapy as treatment of spinal metastasis. Electrochemotherapy allowed a successful treatment of metastatic spinal melanoma. However, we believe that there is a strong scientific rationale to support the potential utility of electrochemotherapy as a novel treatment of spinal metastasis, regardless of the histological types.

Original languageEnglish
Pages (from-to)E1340-E1346
JournalSpine
Volume40
Issue number24
DOIs
Publication statusPublished - 2015

Fingerprint

Electrochemotherapy
Melanoma
Neoplasm Metastasis
Bleomycin
Therapeutics
Karnofsky Performance Status
Electrodes
Laminectomy
Pain Measurement
Needles
Neoplasms

Keywords

  • Bleomycin
  • Cliniporator
  • Electric pulses
  • Electrochemotherapy
  • Electropermeabilization
  • Electroporation
  • Melanoma
  • Metastasis
  • Spinal tumor
  • Tumor ablation

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Electrochemotherapy to metastatic spinal melanoma : A novel treatment of spinal metastasis? / Gasbarrini, Alessandro; Campos, Wuilker Knoner; Campanacci, Laura; Boriani, Stefano.

In: Spine, Vol. 40, No. 24, 2015, p. E1340-E1346.

Research output: Contribution to journalArticle

Gasbarrini, Alessandro ; Campos, Wuilker Knoner ; Campanacci, Laura ; Boriani, Stefano. / Electrochemotherapy to metastatic spinal melanoma : A novel treatment of spinal metastasis?. In: Spine. 2015 ; Vol. 40, No. 24. pp. E1340-E1346.
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AB - Study Design. Preliminary report of new antitumor treatment. Objective. To evaluate the effectiveness of electrochemotherapy as a novel treatment of spinal metastasis. Summary of Background Data. Electrochemotherapy is a new antitumor treatment that combines systemic bleomycin with electric pulses delivered locally at the tumor site. These electric pulses permeabilize cell membranes in the tissue, allow bleomycin delivery diffusion inside the cells, and increase bleomycin cytotoxicity. Previous clinical studies have demonstrated the effectiveness of electrochemotherapy in the treatment of several primary and metastatic solid tumors. Methods. Treatment planning for electrode positioning and electrical pulse parameters was prepared for 4 needle electrodes. Mini-open surgery with a left L5 laminectomy was performed to introduce the eletrodes. The patient was treated according to the established Electrochemotherapy Protocol with Bleomycin. Clinical efficacy of electrochemotherapy was evaluated according to a visual analog scale of pain, Oswestry Disability Index 2.0, the Karnofsky Performance Scale, and Response Evaluation Criteria in Solid Tumors. Results. The assessed follow-up period was 48 months after the electrochemotherapy procedure. Neither serious electrochemotherapy- related adverse events, nor bleomycin toxicity were reported. Overall improvement in pain according to Oswestry Disability Index 2.0 and Karnofsky Performance Scale outcomes was better. Conclusion. Our case represents, to our knowledge, the first one to test the potential role of electrochemotherapy as treatment of spinal metastasis. Electrochemotherapy allowed a successful treatment of metastatic spinal melanoma. However, we believe that there is a strong scientific rationale to support the potential utility of electrochemotherapy as a novel treatment of spinal metastasis, regardless of the histological types.

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