Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Surgery. 2013 Nov;154(5):991-9. doi: 10.1016/j.surg.2013.04.054. Epub 2013 Sep 3.
Peritoneal carcinomatosis is a poor prognostic factor for patients with gastrointestinal, gynecologic, and pancreatic cancer. Cisplatin (CDDP) is among the most effective anti-cancer agents, although its adverse effects remain unresolved. For the treatment of peritoneal carcinomatosis with high-dose CDDP, it is necessary to design a new delivery system of CDDP that can decrease systemic toxicity and achieve a better targeted, high-dose chemotherapy.
Microspheres were prepared from gelatin of a nontoxic, biodegradable material for the sustained release of CDDP. The gelatin microspheres incorporating CDDP (GM-CDDP) were injected intraperitoneally into a mouse model of peritoneal carcinomatosis; their therapeutic efficacy and adverse effects were evaluated in comparison with intraperitoneal administration of free CDDP.
GM-CDDP released CDDP in the peritoneal cavity as a result of gelatin biodegradation. Mice treated with microspheres in the peritoneal cavity lived longer than mice treated with free CDDP (74 ± 23 vs 40 ± 23 days; P < .05). The mice treated with GM-CDDP also lost no weight, whereas the free CDDP group lost approximately 20% body weight (106 ± 5% vs 80 ± 7%; P < .001; body weight on day 1 = 100%). GM-CDDP significantly decreased the nephrotoxicity and hematotoxicity of CDDP.
GM decreased the adverse effects of CDDP and allowed high-dose intraperitoneal chemotherapy with the control of CDDP. This technique of gradual local release may allow us to provide a high-dose, targeted, intraperitoneal chemotherapy with CDDP, resulting in enhanced anti-cancer effects. These gelatin microspheres may be useful as a drug carrier for the treatment of peritoneal carcinomatosis.
腹膜转移是胃肠道癌、妇科癌症和胰腺癌患者预后不良的一个因素。顺铂(CDDP)是最有效的抗癌药物之一,但其不良反应仍未得到解决。为了用高剂量 CDDP 治疗腹膜转移,有必要设计一种新的 CDDP 输送系统,以降低全身毒性并实现更好的靶向、高剂量化疗。
采用一种非毒性、可生物降解材料的明胶制备微球,用于 CDDP 的持续释放。将载有 CDDP 的明胶微球(GM-CDDP)注入腹膜癌模型的小鼠腹腔内;将其与腹腔内给予游离 CDDP 的疗效和不良反应进行比较。
GM-CDDP 由于明胶的生物降解而在腹腔内释放 CDDP。用微球治疗的小鼠在腹腔内的存活时间长于用游离 CDDP 治疗的小鼠(74 ± 23 天比 40 ± 23 天;P <.05)。用 GM-CDDP 治疗的小鼠体重也没有减轻,而游离 CDDP 组体重减轻了约 20%(106 ± 5%比 80 ± 7%;P <.001;第 1 天体重为 100%)。GM-CDDP 显著降低了 CDDP 的肾毒性和血液毒性。
GM 降低了 CDDP 的不良反应,并允许用 CDDP 进行高剂量腹腔内化疗,从而控制 CDDP。这种逐渐局部释放的技术可能使我们能够提供高剂量、靶向、腹腔内化疗,增强抗癌效果。这些明胶微球可能是治疗腹膜转移的有用药物载体。