Clavo Bernardino, Robaina Francisco, Montz Ricardo, Domper Marta, Carames Miguel A, Morera Jesús, Pinar Beatriz, Hernandez María A, Santullano Victoria, Carreras José Luis
Department of Radiation Oncology-Research, Dr. Negrin University Hospital, Las Palmas, Spain.
J Neurosurg. 2006 Apr;104(4):537-41. doi: 10.3171/jns.2006.104.4.537.
In previous studies the authors have shown potential increases in locoregional blood flow and oxygenation in tumors by using electrical cervical spinal cord stimulation (SCS). In the present report they demonstrate the effect of cervical SCS on brain tumor metabolism, as assessed using [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET).
Cervical devices were inserted in 11 patients who had high-grade gliomas, six of which had recurred. While the SCS device was deactivated, each patient underwent an initial FDG-PET study to clarify the clinical status. A second FDG-PET study was performed later the same day while the stimulation device was activated to determine the effect of cervical SCS on glucose metabolism. All 11 patients were invaluable for this PET study. Basal glucose metabolism was higher in the tumor than in the peritumoral areas (p = 0.048). There was a significant increase in glucose uptake during cervical SCS in both the tumor (p = 0.035) and the peritumoral (p = 0.001) areas, with measured increases of 43 and 38%, respectively. The estimated potential maximal residual activity of the first FDG dose's contribution to the activity on the second scan was 18.5 +/- 1% or less.
This PET study is the first in which is described the effect of cervical SCS on glucose metabolism in brain tumors and supports previous study data indicating a modification of locoregional blood flow and oxygenation by cervical SCS. These results open up new approaches to modifying the effect of radiochemotherapy in the treatment of malignant brain tumors.
在先前的研究中，作者已表明通过使用颈脊髓电刺激（SCS）可使肿瘤局部区域的血流和氧合作用潜在增加。在本报告中，他们展示了颈SCS对脑肿瘤代谢的影响，这是通过[18F]氟脱氧葡萄糖 - 正电子发射断层扫描（FDG - PET）进行评估的。
为11例患有高级别胶质瘤的患者插入了颈部装置，其中6例为复发性肿瘤。在SCS装置停用期间，每位患者均接受了首次FDG - PET研究以明确临床状况。在同一天晚些时候，当刺激装置开启时进行了第二次FDG - PET研究，以确定颈SCS对葡萄糖代谢的影响。所有11例患者均对该PET研究具有重要价值。肿瘤组织中的基础葡萄糖代谢高于瘤周区域（p = 0.048）。在颈SCS期间，肿瘤（p = 0.035）和瘤周（p = 0.001）区域的葡萄糖摄取均显著增加，测量到的增加幅度分别为43%和38%。第一次FDG剂量对第二次扫描活性的估计潜在最大残留活性为18.5±1%或更低。
这项PET研究首次描述了颈SCS对脑肿瘤葡萄糖代谢的影响，并支持先前的研究数据，表明颈SCS可改变局部区域的血流和氧合作用。这些结果为改变放射化学疗法在恶性脑肿瘤治疗中的效果开辟了新途径。
