Abe Tetsuya, Sakane Masataka, Ikoma Toshiyuki, Kobayashi Mihoko, Nakamura Satoshi, Ochiai Naoyuki
Department of Orthopedic Surgery, and Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
J Neurosurg Spine. 2008 Nov;9(5):502-10. doi: 10.3171/SPI.2008.9.11.502.
Bone is frequently the first site and the only site of breast cancer at recurrence. Local control is important especially for metastatic spine cancer, because epidural spinal cord compression is significantly associated with the quality of life and survival of these patients. The authors have developed a local delivery system of paclitaxel in the form of hydroxyapatite-alginate composite beads. This study was conducted to clarify the therapeutic effect in a rat model of metastatic spine cancer.
Twenty-one rats with metastatic spine cancer were divided into 3 groups: a local treatment group (6 rats), a systemic treatment group (9 rats), and a control group (6 rats). The hind-limb motor function of the animals was monitored daily by using the Basso-Beattie-Bresnahan scale. The authors monitored the disease-free time and survival times. The log-rank test was used to define statistically significant differences between the 3 groups.
The animals in the control group developed hind-limb paralysis at a mean of 10.8 days and died at a mean of 16.0 days. The animals treated with 2.4 wt% of paclitaxel-loaded hydroxyapatite-alginate composite beads (the local treatment group) showed a 140-150% increase in the disease-free time and survival time compared with that of the control group. Although an approximately 30-fold higher dosage of paclitaxel was administered, the therapeutic effect was not evident in the systemic treatment group.
Intraosseous delivery of paclitaxel-loaded hydroxyapatite-alginate composite beads delayed paralysis caused by metastatic spine cancer in rats. The results indicate that intraosseous chemotherapy may provide an effective local treatment of metastatic spine cancer.
骨常常是乳腺癌复发的首个部位及唯一部位。局部控制尤为重要，特别是对于转移性脊柱癌，因为硬膜外脊髓压迫与这些患者的生活质量和生存期显著相关。作者研发了一种以羟基磷灰石 - 海藻酸盐复合珠形式的紫杉醇局部给药系统。本研究旨在阐明其在转移性脊柱癌大鼠模型中的治疗效果。
21只患有转移性脊柱癌的大鼠被分为3组：局部治疗组（6只大鼠）、全身治疗组（9只大鼠）和对照组（6只大鼠）。每天使用Basso - Beattie - Bresnahan评分量表监测动物的后肢运动功能。作者监测无病时间和生存时间。采用对数秩检验来确定3组之间的统计学显著差异。
对照组动物平均在10.8天出现后肢麻痹，平均在16.0天死亡。用含2.4 wt%紫杉醇的羟基磷灰石 - 海藻酸盐复合珠治疗的动物（局部治疗组）与对照组相比，无病时间和生存时间增加了140 - 150%。尽管全身治疗组给予的紫杉醇剂量大约高30倍，但其治疗效果并不明显。
骨内递送含紫杉醇的羟基磷灰石 - 海藻酸盐复合珠可延缓大鼠转移性脊柱癌所致的麻痹。结果表明骨内化疗可能为转移性脊柱癌提供有效的局部治疗。
