Yang Qian, Wang Xiao-dong, Chen Jie, Tian Chun-xiang, Li Hong-jiang, Chen Yu-Juan, Lv Qing
Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Tumour Biol. 2012 Dec;33(6):2341-8. doi: 10.1007/s13277-012-0496-y. Epub 2012 Sep 5.
The purpose of this study was to understand the short-term therapeutic effects of an activated carbon nanoparticle-epirubicin suspension for regional lymphatic chemotherapy in patients with breast cancer. One hundred and twenty patients with stage I, II, or III primary breast cancer were randomly divided into three groups: the lymphatic chemotherapy group using the activated carbon nanoparticle-epirubicin suspension, the epirubicin control group, and the activated carbon control group. Each group of 40 patients was further divided into two subgroups with the drug injected either 24 or 48 h before surgery. The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) assay was used to determine cancer cell apoptotic indices in metastatic lymph nodes. The epirubicin concentration in the black-stained lymph nodes in the lymphatic chemotherapy treatment group was 4,144.64 ± 2,426.44 ng/g, which is significantly higher than in the epirubicin control group (335.87 ± 212.82 ng/g, P < 0.001). The plasma epirubicin concentrations at 0.5, 1.5, and 24 h postinjection in the regional lymphatic chemotherapy treatment group were significantly lower than in the epirubicin control group (P < 0.001). Tolerable mild pain was observed at the injection area after administration of the epirubicin-activated carbon nanoparticle suspension. No regional necrosis or adverse effects were found. The TUNEL assay demonstrated that there was no significant difference in the apoptotic indices in the metastatic lymph nodes from the three groups. Performing lymphatic chemotherapy by regionally injecting the epirubicin-activated carbon nanoparticle suspension could significantly enhance the drug concentration in the stained lymph nodes and lower the plasma drug concentration. The epirubicin-activated carbon nanoparticle suspension has the ability to release the drug slowly in the lymph nodes and, as a result, can prolong the chemotherapeutic effects.
本研究旨在了解活性炭纳米颗粒-表柔比星混悬液对乳腺癌患者进行区域淋巴化疗的短期治疗效果。120例I、II或III期原发性乳腺癌患者被随机分为三组：使用活性炭纳米颗粒-表柔比星混悬液的淋巴化疗组、表柔比星对照组和活性炭对照组。每组40例患者进一步分为两个亚组，分别在手术前24小时或48小时注射药物。采用末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸生物素缺口末端标记法（TUNEL法）测定转移淋巴结中的癌细胞凋亡指数。淋巴化疗治疗组中黑色染色淋巴结中的表柔比星浓度为4144.64±2426.44 ng/g，显著高于表柔比星对照组（335.87±212.82 ng/g，P<0.001）。区域淋巴化疗治疗组注射后0.5、1.5和24小时的血浆表柔比星浓度显著低于表柔比星对照组（P<0.001）。给予表柔比星-活性炭纳米颗粒混悬液后，注射部位观察到可耐受的轻度疼痛。未发现区域坏死或不良反应。TUNEL法显示，三组转移淋巴结中的凋亡指数无显著差异。通过区域注射表柔比星-活性炭纳米颗粒混悬液进行淋巴化疗可显著提高染色淋巴结中的药物浓度并降低血浆药物浓度。表柔比星-活性炭纳米颗粒混悬液能够在淋巴结中缓慢释放药物，因此可以延长化疗效果。
