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Title: Effect of cervical spinal cord stimulation on regional blood flow and oxygenation in advanced head and neck tumours
Authors: Clavo, Bernardino 
Robaina, F.
Catalá, L.
Pérez, J. L.
Lloret, M.
Caramés, M. Á 
Morera, J.
López, L.
Suárez, G.
Macías, D.
Rivero, J.
Hernández, M. A.
UNESCO Clasification: 32 Ciencias médicas
320713 Oncología
Keywords: Blood flow
Colour Doppler
Head & neck cancer
Spinal cord stimulation
Transcranial Doppler, et al
Issue Date: 2004
Journal: Annals of Oncology 
Abstract: 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.
ISSN: 0923-7534
DOI: 10.1093/annonc/mdh189
Source: Annals of Oncology[ISSN 0923-7534],v. 15(5), p. 802-807
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