Division of Thoracic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Ann Thorac Surg. 2011 Apr;91(4):1077-83; discussion 1083-4. doi: 10.1016/j.athoracsur.2010.12.040.
Surgical resection remains the most effective treatment option for patients with early stage non-small cell lung cancer; however, comorbidities and poor pulmonary reserve often limit the extent of resection. Limited resections are associated with a twofold to threefold increase in locoregional recurrence, suggesting that microscopic disease remains near the resection margin. We hypothesized that local delivery of paclitaxel through 100-nm expansile polymer nanoparticles (pax-eNP) immediately after tumor resection could prevent local recurrence.
Primary tumors, initiated on the dorsum of C57BL/6J mice through subcutaneous injection of 750,000 Lewis lung carcinoma cells, were excised when tumor volume reached 300 mm(3). After resection, animals were randomized to receive 300 μg paclitaxel intravenously or as pax-eNP locally at the tumor resection site versus unloaded eNP or saline controls.
In all mice receiving saline, unloaded eNP, or paclitaxel intravenously, visible local tumor recurrence developed at a median of 6 days. In contrast, tumor recurrence after pax-eNP was delayed to 10 days (pax-eNP versus all other groups, Kaplan-Meier, p < 0.05). Delay in local recurrence was associated with increased survival in the pax-eNP group (16 days) versus all other groups (11 and 12 days, p < 0.05).
The pax-eNP placed at the time of surgical resection delayed local tumor recurrence and modestly prolonged survival in a murine Lewis lung carcinoma recurrence model.
手术切除仍然是治疗早期非小细胞肺癌患者的最有效治疗选择;然而,合并症和肺储备功能差常常限制了切除范围。有限的切除术与局部区域复发的两倍到三倍增加相关,这表明在切除边缘附近仍存在显微镜下的疾病。我们假设,在肿瘤切除后立即通过 100nm 膨胀聚合物纳米颗粒(pax-eNP)局部递送电紫杉醇可以预防局部复发。
通过皮下注射 750,000 个 Lewis 肺癌细胞在 C57BL/6J 小鼠背部起始原发性肿瘤,当肿瘤体积达到 300mm3 时将其切除。切除后,动物随机接受 300μg 紫杉醇静脉内给药或作为 pax-eNP 局部施用于肿瘤切除部位,与未加载的 eNP 或生理盐水对照。
在所有接受生理盐水、未加载的 eNP 或紫杉醇静脉内给药的小鼠中,可见的局部肿瘤复发在中位数为 6 天发生。相比之下,pax-eNP 后肿瘤复发延迟至 10 天(pax-eNP 与所有其他组相比,Kaplan-Meier,p<0.05)。局部复发的延迟与 pax-eNP 组的生存时间延长相关(16 天),而与所有其他组相比(11 天和 12 天,p<0.05)。
在手术切除时放置的 pax-eNP 在 Lewis 肺癌复发模型中延迟了局部肿瘤复发,并适度延长了生存时间。