Krause M, Hessel F, Zips D, Hilberg F, Baumann M
Department of Radiation Oncology, Medical Faculty Carl Gustav Carus, University of Technology Dresden, Fetscherstr, 74, 01307 Dresden, Germany.
Radiother Oncol. 2004 Jul;72(1):95-101. doi: 10.1016/j.radonc.2004.05.003.
Experiments performed by others have shown that inhibition of EGFR before and after single dose irradiation prolonged growth delay and improved local tumour control. This suggests that adjuvant EGFR inhibition can inactivate clonogens that survived irradiation. To test this hypothesis local tumour control was investigated after fractionated radiotherapy and adjuvant EGFR-TK inhibition.
FaDu hSCC xenografts were irradiated with 30 fractions in 6 weeks with total doses of 30-100Gy. After the end of fractionated irradiation, BIBX1382BS was administered daily orally over a time period of 75 days. Tumour volumes were determined two times per week, the volume doubling time during adjuvant treatment was calculated for progressing and recurrent tumours. Local tumour control was investigated 120 days after end of irradiation.
Adjuvant BIBX1382BS significantly reduced the tumour growth rate but did not improve local tumour control. The TCD(50) values were 66.1Gy (95% C.I.: 59; 73Gy) after adjuvant BIBX1382BS treatment and 67.9Gy (61; 75Gy) for control tumours (P=0.9).
These data indicate that, although growth of recurrent tumour cells after irradiation is dependent on the EGFR pathway, tumour cells retain their clonogenic potential despite of EGFR inhibition. The results imply also that a decreased tumour growth rate does not necessarily allow conclusions on enhanced inactivation of clonogenic cells when antiproliferative drugs are combined with radiation.
其他研究人员进行的实验表明,在单次照射前后抑制表皮生长因子受体(EGFR)可延长肿瘤生长延迟时间并改善局部肿瘤控制情况。这表明辅助性EGFR抑制可使照射后存活的克隆原细胞失活。为验证这一假设,我们研究了分次放疗及辅助性EGFR酪氨酸激酶抑制后的局部肿瘤控制情况。
用总剂量为30 - 100Gy的射线在6周内对FaDu人鳞状细胞癌异种移植瘤进行30次分割照射。分次照射结束后,在75天的时间里每日口服BIBX1382BS。每周测定两次肿瘤体积,计算辅助治疗期间进展期和复发性肿瘤的体积倍增时间。在照射结束120天后研究局部肿瘤控制情况。
辅助性使用BIBX1382BS可显著降低肿瘤生长速率,但未改善局部肿瘤控制情况。辅助性使用BIBX1382BS治疗后的肿瘤控制剂量(TCD)(50)值为66.1Gy(95%可信区间:59;73Gy),对照肿瘤的该值为67.9Gy(61;75Gy)(P = 0.9)。
这些数据表明,尽管照射后复发性肿瘤细胞的生长依赖于EGFR途径,但尽管抑制了EGFR,肿瘤细胞仍保留其克隆原性潜能。结果还表明,当抗增殖药物与放疗联合使用时,肿瘤生长速率降低并不一定意味着克隆原性细胞的失活增强。