Combining Radiation Therapy With Surgery

“This research opens the door to developing a clinical protocol for curing human spinal cord injuries using conventional therapies,” said lead researcher Nurit Kalderon, Ph.D, Sloan-Kettering Institute for Cancer Research in New York City.

In the research, the scientists made a severe crush injury, similar to a human contusion/fracture injury, in spinal cord of adult rats just below the waist. In crush injuries, tissue decay is exacerbated by the secondary damage caused by massive swelling as fluids build up from the injured blood vessels. When the researchers administered radiation alone, there was no detectable beneficial effect on the body’s repair of the crushed cord.

They then made longitudinal micro-incisions down the centre of the injured cord within the first 24 hours after injury to release the fluid buildup. There was significant reduction in the size of lesion site. They then combined the radiation treatment with the microsurgery. When a midline incision was performed at one hour after injury, followed by localized radiation therapy given for ten days starting on day ten after injury, there was nearly a two-fold improvement in the body’s ability to heal the injured cord compared with untreated rats. This suggests that fluid accumulation and swelling must first be prevented if the radiation therapy is to be effective in promoting wound repair.

The researchers also tested a third level of treatment. They added ten minutes of treadmill exercise five days a week to the radiation therapy, starting at the second week after injury. Again, the spinal cord ability to repair itself was markedly improved. Rats treated with incisions followed by radiation therapy and regular treadmill exercise saw a three-fold improvement in the body’s ability to repair the severely crushed cord.; Source: Public Library of Science