Itasaka Satoshi, Komaki Ritsuko, Herbst Roy S, Shibuya Keiko, Shintani Tomoaki, Hunter Nancy R, Onn Amir, Bucana Corazon D, Milas Luka, Ang K Kian, O'Reilly Michael S
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Int J Radiat Oncol Biol Phys. 2007 Mar 1;67(3):870-8. doi: 10.1016/j.ijrobp.2006.10.030.
Clinical trials of antiangiogenic agents used alone for advanced malignancy have been disappointing but preclinical studies suggest that the addition of radiation therapy could improve antitumor efficacy. To test the hypothesis that antiangiogenic therapy combined with radiation therapy can overcome the limitations of antiangiogenic monotherapy, we studied the effects of endostatin combined with radiation on the growth and vascularization of A431 human epidermoid carcinomas growing intramuscularly in the legs of mice.
Mice with established A431 human epidermoid leg tumors were treated with radiation, endostatin, both radiation and endostatin, or vehicle control. The experiment was repeated and mice from each group were killed at 2, 7, and 10 days after irradiation so that tumor tissue could be obtained to further analyze the kinetics of the antitumor, antivascular, and antiangiogenic response to therapy.
Endostatin enhanced the antitumor effects of radiation, and prolonged disease-free survival was observed in the combined treatment group. Endothelial cell proliferation was increased in tumors after irradiation but was blocked by the concurrent administration of endostatin, and the combination of endostatin with radiation enhanced endothelial cell apoptosis within 48 h after irradiation. Expression of vascular endothelial growth factor, interleukin-8, and matrix metalloproteinase-2 were increased in tumors after irradiation, and this increase was blocked by concurrent administration of endostatin.
These data indicate that endostatin can block tumor revascularization after radiation therapy and thereby augment radioresponse.
单独使用抗血管生成药物治疗晚期恶性肿瘤的临床试验效果不佳,但临床前研究表明,联合放射治疗可提高抗肿瘤疗效。为验证抗血管生成治疗联合放射治疗可克服抗血管生成单一疗法局限性这一假说,我们研究了内皮抑素联合放射治疗对在小鼠腿部肌肉内生长的A431人表皮样癌生长和血管生成的影响。
对已形成A431人表皮样腿部肿瘤的小鼠进行放射治疗、内皮抑素治疗、放射与内皮抑素联合治疗或赋形剂对照治疗。重复该实验,在照射后第2、7和10天处死每组小鼠,以便获取肿瘤组织,进一步分析治疗的抗肿瘤、抗血管和抗血管生成反应动力学。
内皮抑素增强了放射治疗的抗肿瘤效果,联合治疗组观察到无病生存期延长。照射后肿瘤内内皮细胞增殖增加,但同时给予内皮抑素可阻断该增殖,内皮抑素与放射联合治疗可在照射后48小时内增强内皮细胞凋亡。照射后肿瘤内血管内皮生长因子、白细胞介素-8和基质金属蛋白酶-2的表达增加,同时给予内皮抑素可阻断这种增加。
这些数据表明,内皮抑素可阻断放射治疗后的肿瘤再血管化,从而增强放射反应。