Electrochemotherapy in radiotherapy-resistant epidural spinal cord compression in metastatic cancer patients

Frederic Deschamps, Lambros Tselikas, Steven Yevich, Baptiste Bonnet, Charles Roux, Adrian Kobe, Benjamin Besse, Kevin Berthelot, Amelie Gaudin, Lluis M. Mir, Thierry de Baere

    Résultats de recherche: Contribution à un journalArticleRevue par des pairs

    9 Citations (Scopus)

    Résumé

    Objective: To report efficacy and safety of percutaneous electrochemotherapy (ECT) in patients with radiotherapy-resistant metastatic epidural spinal cord compression (MESCC). Material/ methods: This retrospective study analyzed all consecutive patients treated with bleomycin-based ECT between February-2020 and September-2022 in a single tertiary referral cancer center. Changes in pain were evaluated with the Numerical Rating Score (NRS), in neurological deficit with the Neurological Deficit Scale, and changes in epidural spinal cord compression were evaluated with the epidural spinal cord compression scale (ESCCS) using an MRI. Results: Forty consecutive solid tumour patients with previously radiated MESCC and no effective systemic treatment options were eligible. With a median follow-up of 5.1 months [1–19.1], toxicities were temporary acute radicular pain (25%), prolonged radicular hypoesthesia (10%), and paraplegia (7.5%). At 1 month, pain was significantly improved over baseline (median NRS: 1.0 [0–8] versus 7.0 [1.0–10], P < .001) and neurological benefits were considered as marked (28%), moderate (28%), stable (38%), or worse (8%). Three-month follow-up (21 patients) confirmed improved over baseline (median NRS: 2.0 [0–8] versus 6.0 [1.0–10], P < .001) and neurological benefits were considered as marked (38%), moderate (19%), stable (33.5%), and worse (9.5%). One-month post-treatment MRI (35 patients) demonstrated complete response in 46% of patients by ESCCS, partial response in 31%, stable disease in 23%, and no patients with progressive disease. Three-month post-treatment MRI (21 patients) demonstrated complete response in 28.5%, partial response in 38%, stable disease in 24%, and progressive disease in 9.5%. Conclusions: This study provides the first evidence that ECT can rescue radiotherapy-resistant MESCC.

    langue originaleAnglais
    Pages (de - à)62-68
    Nombre de pages7
    journalEuropean Journal of Cancer
    Volume186
    Les DOIs
    étatPublié - 1 juin 2023

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