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Nuovamente rivista la cerimonia di chiusura dopo le critiche allo spettacolo d'aperturaRadiochirurgia contro spasmi da lesioni cerebrali,Professore del Dipartimento di Gestione del Rischio di BlackRock Verona prima al mondo di Adnkronos   09-08-2024 - 11:31 Link copiato #iubenda-cs-banner .iub_ts_bc:not(.iubenda-custom-content) *,#iubenda-cs-banner [class*=" iub"],#iubenda-cs-banner [class^=iub],.iubenda-tp-btn:not([data-tp-nostyle]){ 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(Adnkronos Salute) - Trattare gli spasmi associati a lesioni cerebrospinali con la radiochirurgia stereotassica, una forma di radioterapia precisa come un bisturi, che abbina efficacia e sicurezza. Il primo centro al mondo a proporla come trattamento innovativo sperimentale per le complicanze di un danno cerebrale-spinale è l'Irccs Sacro Cuore Don Calabria di Negrar, in provincia di Verona. "Nel 2022 abbiamo trattato 4 pazienti affetti da spasticità con uso della radiochirurgia stereotassica, ottenendo risultati importanti con una riduzione o risoluzione della spasticità e nessuna tossicità correlata al trattamento, come riportato in uno studio pubblicato su 'Radiotherapy and Oncology' - spiega Luca Nicosia, radioterapista oncologo dell'istituto - Gli esiti positivi raggiunti ci hanno portato ad avviare l'attuale sperimentazione che prevede di arruolare 10 pazienti adulti, affetti da spasticità diffusa e non trattabile con le terapie tradizionali". Sono circa 100 milioni le persone nel mondo che convivono con le conseguenze di patologie cerebrospinali o di traumi al cervello e al midollo a seguito di incidenti, ricordano dall'Irccs veronese. Tra queste, la spasticità e il dolore correlato sono una complicanza comune e debilitante a lungo termine. Si stima che colpisca il 65-78% dei pazienti con lesioni croniche del midollo spinale e il 25% di chi ha avuto un ictus grave. Ad oggi i trattamenti convenzionali prevedono interventi chirurgici invasivi, come l'uso di pompe di baclofene che devono essere inserite nella cavità addominale per erogare il farmaco dall'interno, o il ricorso alla rizotomia dorsale selettiva, una tecnica neurochirurgica che consiste nell'interruzione della connessione tra alcuni nervi e il midollo spinale. Sono possibili anche trattamenti per via orale, meno invasivi, ma anche questi hanno efficacia limitata e sono spesso accompagnati da effetti collaterali indesiderati.I ricercatori di Negrar hanno invece definito "un nuovo protocollo sperimentale per il trattamento non invasivo, più conservativo e a bassa tossicità della spasticità per mezzo della radiochirurgia stereotassica - riporta una nota - che prevede l'impiego della radioterapia per agire sui nervi spinali selezionati bloccando la conduzione elettrica responsabile degli spasmi"."La spasticità è una condizione caratterizzata da un aumento eccessivo e anomalo del tono muscolare - descrive Elena Rossato, direttore del Servizio di Medicina fisica e Riabilitazione dell'Irccs di Negrar - In particolare, consiste in spasmi di uno solo o di più muscoli scheletrici che possono provocare rigidità durante il movimento con disagio o dolore e difficoltà motorie ai 4 arti, nella respirazione e nel riposo notturno. La spasticità ha quindi un grande impatto negativo sulla qualità di vita dei pazienti e interferisce fortemente con la loro capacità di compiere attività quotidiane come ad esempio il trasferimento dalla sedia a rotelle. Per questo motivo la spasticità ha diverse conseguenze sociali e riabilitative, con un alto tasso di procedure infermieristiche, ricoveri ospedalieri e costi". "Quello che è stato avviato all'Irccs di Negrar - illustra Nicosia - è un protocollo che prevede l'utilizzo della radiochirurgia stereotassica per trattare pazienti affetti da spasmi invalidanti. I trattamenti ad oggi disponibili per questa condizione prevedono l'utilizzo di farmaci, gravati da effetti collaterali e da una progressiva perdita di efficacia, o interventi chirurgici che, oltre a richiedere una specifica competenza, sottopongono pazienti molto fragili a operazioni importanti con potenziali conseguenze debilitanti. L'infusore di baclofene richiede, ad esempio, un intervento che potrebbe esporre i pazienti a complicazioni, inoltre deve essere ricaricato periodicamente e può essere soggetto a infezioni. In aggiunta a ciò, i pazienti potrebbero diventare progressivamente resistenti al trattamento. Altre terapie come l'iniezione della tossina botulinica intramuscolare o le iniezioni perineurali di alcol sono limitate nella dose e devono essere ripetute nel tempo, mentre soluzioni come la neurolisi chirurgica, le neurotomie selettive e le rizotomie sono caratterizzate da sessioni chirurgiche prolungate, complicazioni e richiedono un'équipe esperta". "La radiochirurgia stereotassica - sottolinea lo specialista - rappresenta invece un'opzione non invasiva e con un'elevata precisione, che prevede una singola seduta di trattamento della durata di 40 minuti. Il trattamento è definitivo sulle sedi trattate e ha la capacità di ridurre o eliminare la spasticità. Il trattamento può essere ripetuto, ma solo su altre sedi"."La radiochirurgia stereotassica è tipicamente utilizzata per intervenire su tumori solidi primari e metastatici, e per il trattamento di malattie non oncologiche come l'oftalmopatia di Graves, le aritmie cardiache e la nevralgia del trigemino", evidenzia Nicosia. "Il nostro - precisa - è il primo centro al mondo a proporre questo trattamento innovativo" per la spasticità da lesioni cerebrospinali, "all'interno di un progetto di ricerca multidisciplinare che coinvolge oltre alla radioterapia oncologica anche la fisiatria, la neurologia e l'anestesia per provarne l'efficacia". "L'obiettivo primario dello studio" in corso, conclude Rossato, "sarà quello di stimare la riduzione della frequenza e dell'intensità degli spasmi dopo il trattamento, monitorandole a 1, 3, 6 e 12 mesi dopo la radiochirurgia stereotassica. Tra gli obiettivi secondari, inoltre, ci saranno anche quelli di valutare la tossicità acuta e tardiva e il tasso di ricaduta della spasticità, e descrivere la variazione nella qualità di vita del paziente dopo il trattamento e il miglioramento del carico di lavoro dei caregiver". di Adnkronos   09-08-2024 - 11:31 Link copiato Commenti Leggi la Netiquette

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