Adam Markus, Ottenjann Sigrid, Künzel Georg, Busch Raymonde, Erhardt Wolf, Nieder Carsten, Molls Michael
Praxis für Strahlentherapie und Radioonkologie, Röntgenstrasse 4, 82362 Weilheim.
Strahlenther Onkol. 2006 Apr;182(4):231-9. doi: 10.1007/s00066-006-1506-z.
Tirapazamine (TPZ) is an anticancer drug that is selectively activated by the low oxygen environment in solid tumors. Furthermore, TPZ also enhances the tumor cell-killing effect of cisplatin. So far, detailed information on the toxicity of combined treatment is rare. The authors evaluated the toxicity of TPZ in combination with cisplatin in a mouse tumor model. For this purpose, general toxicity was monitored and all inner organs were examined histologically.
RIF-1 fibrosarcomas of murine origin growing in the right hindfoot dorsum of C3H mice were used. The animals were treated with 10 x 2 Gy irradiation plus six i.p. injections of 4 mg/kg cisplatin (total dose 24 mg/kg) together with varying doses of TPZ (0-28 mg/kg per injection; total dose 0, 43.2, 86.4, 129.6, 151.2, 172.8 mg/kg). Treatment was applied within 2 weeks (Figure 1). Total observation period was up to 35 days.
Combined treatment with TPZ led to a dose-dependent, significant decrease in motor activity (Table 1) and body weight and an increase in mortality (Figures 2 and 3, Tables 2 and 3). Histological analyses showed areas of necrosis in the heart, liver and kidney and gastric ulcers (Table 4). Cisplatin alone produced no severe toxicity. Tumor doubling times were TPZ dose-dependent and comparable with data from the literature (Figures 4 and 5, Table 3).
Unlike most data from the literature a dose-dependent increase in toxicity was seen when adding TPZ to a standard treatment of cisplatin plus irradiation. To the authors' knowledge this is the first study histologically examining in detail the organ toxicity of TPZ in a mouse model. Furthermore, they expand the rare data on long-term toxicity after TPZ plus cisplatin in a fractionated therapy regimen. The results question the usefulness of frequently performed therapeutic studies where only short-term treatment and observation endpoints are used, since essential toxicities are likely to be overlooked.
替拉扎明(TPZ)是一种抗癌药物,可被实体瘤中的低氧环境选择性激活。此外,TPZ还可增强顺铂对肿瘤细胞的杀伤作用。到目前为止,关于联合治疗毒性的详细信息很少。作者在小鼠肿瘤模型中评估了TPZ与顺铂联合使用的毒性。为此,监测了一般毒性,并对所有内脏器官进行了组织学检查。
使用生长在C3H小鼠右后足背的鼠源性RIF-1纤维肉瘤。动物接受10×2 Gy照射加6次腹腔注射4 mg/kg顺铂(总剂量24 mg/kg),同时给予不同剂量的TPZ(每次注射0 - 28 mg/kg;总剂量0、43.2、86.4、129.6、151.2、172.8 mg/kg)。治疗在2周内进行(图1)。总观察期长达35天。
TPZ联合治疗导致运动活性剂量依赖性显著降低(表1)、体重下降和死亡率增加(图2和图3,表2和表3)。组织学分析显示心脏、肝脏和肾脏有坏死区域以及胃溃疡(表4)。单独使用顺铂未产生严重毒性。肿瘤倍增时间呈TPZ剂量依赖性,与文献数据相当(图4和图5,表3)。
与文献中的大多数数据不同,在顺铂加照射的标准治疗中添加TPZ时,毒性呈剂量依赖性增加。据作者所知,这是第一项在小鼠模型中对TPZ的器官毒性进行详细组织学检查的研究。此外,他们扩展了关于TPZ加顺铂在分次治疗方案中长期毒性的罕见数据。结果对仅使用短期治疗和观察终点的频繁进行的治疗研究的实用性提出了质疑,因为可能会忽略基本毒性。