Non-Thermal Irreversible Electroporation (N-TIRE) and Adjuvant Fractionated Radiotherapeutic Multimodal Therapy for Intracranial Malignant Glioma in a Canine Patient
Non-Thermal Irreversible Electroporation (N-TIRE) and Adjuvant Fractionated Radiotherapeutic Multimodal Therapy for Intracranial Malignant Glioma in a Canine Patient
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DOI：
10.7785/tcrt.2012.500181
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发表时间：
2011-02-01
影响因子：
2.8
通讯作者：
Davalos, R. V.
中科院分区：
文献类型：
--
作者：
Garcia, P. A.;Pancotto, T.;Davalos, R. V.
非热不可逆电穿孔（N-TIRE）已显示出作为各种软组织肿瘤的消融治疗的前景。在这里，我们描述了治疗计划方面和第一次临床应用N-TIRE治疗一个不能手术的，自发性恶性颅内胶质瘤的犬患者。N-TIRE消融术安全进行，有效减小了肿瘤体积和相关颅内高压，并充分改善了患者的神经功能，使其能够根据当前护理标准安全接受连续分割放疗（RT）。尽管进行性放射性脑病导致犬在N-TIRE治疗后149天死亡，但基于脑部的系列磁共振成像检查实现了完全缓解。该患者的生存时间与通过标准切除手术和连续分割外束RT治疗颅内肿瘤的犬相当。我们的研究结果说明了N-TIRE在体内消融不良脑组织的潜在益处，特别是当传统的细胞减灭术方法不可能或不理想时，并突出了N-TIRE对大脑的潜在放射增敏作用。
Non-thermal irreversible electroporation (N-TIRE) has shown promise as an ablative therapy for a variety of soft-tissue neoplasms. Here we describe the therapeutic planning aspects and first clinical application of N-TIRE for the treatment of an inoperable, spontaneous malignant intracranial glioma in a canine patient. The N-TIRE ablation was performed safely, effectively reduced the tumor volume and associated intracranial hypertension, and provided sufficient improvement in neurological function of the patient to safely undergo adjunctive fractionated radiotherapy (RT) according to current standards of care. Complete remission was achieved based on serial magnetic resonance imaging examinations of the brain, although progressive radiation encephalopathy resulted in the death of the dog 149 days after N-TIRE therapy. The length of survival of this patient was comparable to dogs with intracranial tumors treated via standard excisional surgery and adjunctive fractionated external beam RT. Our results illustrate the potential benefits of N-TIRE for in vivo ablation of undesirable brain tissue, especially when traditional methods of cytoreductive surgery are not possible or ideal, and highlight the potential radiosensitizing effects of N-TIRE on the brain.