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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Main Author: Bohdan W. Chopko
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2014/915904
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author Bohdan W. Chopko
author_facet Bohdan W. Chopko
author_sort Bohdan W. Chopko
collection DOAJ
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 doaj-art-4c9bdcdaae804fd588e032a4431ae9ba2025-02-03T01:07:32ZengWileyCase Reports in Medicine1687-96271687-96352014-01-01201410.1155/2014/915904915904Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot ExperienceBohdan W. Chopko0Department of Neurosurgery, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305-5327, USABackground 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.http://dx.doi.org/10.1155/2014/915904
spellingShingle Bohdan W. Chopko
Endovascular Treatment of Vertebral Column Metastases Using Intra-Arterial Cisplatin: Pilot Experience
Case Reports in Medicine
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
url http://dx.doi.org/10.1155/2014/915904
work_keys_str_mv AT bohdanwchopko endovasculartreatmentofvertebralcolumnmetastasesusingintraarterialcisplatinpilotexperience