Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
Radiat Res. 2012 Jun;177(6):804-12. doi: 10.1667/rr2784.1. Epub 2012 May 18.
In this study, we sought to determine the therapeutic potential of variably sized (50 μm or 500 μm wide, 14 mm tall) parallel microbeam radiation therapy (MRT) alone and in combination with a novel anti-angiogenic peptide, anginex, in mouse mammary carcinomas (4T1)--a moderately hypoxic and radioresistant tumor with propensity to metastasize. The fraction of total tumor volume that was directly irradiated was approximately 25% in each case, but the distance between segments irradiated by the planar microbeams (width of valley dose region) varied by an order of magnitude from 150-1500 μm corresponding to 200 μm and 2000 μm center-to-center inter-microbeam distances, respectively. We found that MRT administered in 50 μm beams at 150 Gy was most effective in delaying tumor growth. Furthermore, tumor growth delay induced by 50 μm beams at 150 Gy was virtually indistinguishable from the 500 μm beams at 150 Gy. Fifty-micrometer beams at the lower peak dose of 75 Gy induced growth delay intermediate between 150 Gy and untreated tumors, while 500 μm beams at 75 Gy were unable to alter tumor growth compared to untreated tumors. However, the addition of anginex treatment increased the relative tumor growth delay after 500 μm beams at 75 Gy most substantially out of the conditions tested. Anginex treatment of animals whose tumors received the 50 μm beams at 150 Gy also led to an improvement in growth delay from that induced by the comparable MRT alone. Immunohistochemical staining for CD31 (endothelial cells) and αSMA (smooth muscle pericyte-associated blood vessels as a measure of vessel normalization) indicated that vessel density was significantly decreased in all irradiated groups and pericyte staining was significantly increased in the irradiated groups on day 14 after irradiation. The addition of anginex treatment further decreased the mean vascular density in all combination treatment groups and further increased the amount of pericyte staining in these tumors. Finally, evidence of tumor hypoxia was found to decrease in tumors analyzed at 1-14 days after MRT in the groups receiving 150 Gy peak dose, but not 75 Gy peak dose. Our results suggest that tumor vascular damage induced by MRT at these potentially clinically acceptable peak entrance doses may provoke vascular normalization and may be exploited to improve tumor control using agents targeting angiogenesis.
在这项研究中,我们旨在确定不同大小(50μm 或 500μm 宽,14mm 高)平行微束放射治疗(MRT)单独以及与新型抗血管生成肽安格宁联合治疗的治疗潜力,在具有转移倾向的中度低氧和放射抵抗的小鼠乳腺癌(4T1)中。在每种情况下,直接照射的肿瘤总体积的分数约为 25%,但是平面微束照射的段之间的距离相差一个数量级,从 150-1500μm 不等,分别对应于 200μm 和 2000μm 的中心到中心微束之间的距离。我们发现,在 150Gy 时以 50μm 束进行的 MRT 最有效地延迟肿瘤生长。此外,在 150Gy 时,50μm 束诱导的肿瘤生长延迟与 500μm 束在 150Gy 时几乎无法区分。在较低的峰值剂量 75Gy 时,50μm 束诱导的生长延迟介于 150Gy 与未治疗肿瘤之间,而 500μm 束在 75Gy 时与未治疗肿瘤相比无法改变肿瘤生长。然而,在测试的条件中,安格宁的添加使在 75Gy 时的 500μm 束的相对肿瘤生长延迟增加最多。在接受 150Gy 的 50μm 束的动物中接受安格宁治疗也导致与单独使用可比 MRT 相比,生长延迟得到改善。CD31(内皮细胞)和αSMA(平滑肌周细胞相关血管作为血管正常化的测量)的免疫组织化学染色表明,在所有照射组中,血管密度显著降低,并且在照射后第 14 天,在照射组中周细胞染色显著增加。在所有联合治疗组中,安格宁的添加进一步降低了平均血管密度,并进一步增加了这些肿瘤中的周细胞染色量。最后,在接受 150Gy 峰值剂量的组中,在接受 MRT 后 1-14 天分析的肿瘤中发现肿瘤缺氧的证据减少,但在接受 75Gy 峰值剂量的组中没有。我们的结果表明,在这些潜在临床可接受的峰值入口剂量下,MRT 诱导的肿瘤血管损伤可能引发血管正常化,并可利用针对血管生成的药物来改善肿瘤控制。