Phillips William T, Bao Ande, Brenner Andrew J, Goins Beth A
Department of Radiology, University of Texas Health Science Center San Antonio, Mail Code 7800, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.
Department of Radiology, University of Texas Health Science Center San Antonio, Mail Code 7800, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA; Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center San Antonio, Mail Code 7777, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.
Adv Drug Deliv Rev. 2014 Sep 30;76:39-59. doi: 10.1016/j.addr.2014.07.001. Epub 2014 Jul 9.
One of the major limitations of current cancer therapy is the inability to deliver tumoricidal agents throughout the entire tumor mass using traditional intravenous administration. Nanoparticles carrying beta-emitting therapeutic radionuclides that are delivered using advanced image-guidance have significant potential to improve solid tumor therapy. The use of image-guidance in combination with nanoparticle carriers can improve the delivery of localized radiation to tumors. Nanoparticles labeled with certain beta-emitting radionuclides are intrinsically theranostic agents that can provide information regarding distribution and regional dosimetry within the tumor and the body. Image-guided thermal therapy results in increased uptake of intravenous nanoparticles within tumors, improving therapy. In addition, nanoparticles are ideal carriers for direct intratumoral infusion of beta-emitting radionuclides by convection enhanced delivery, permitting the delivery of localized therapeutic radiation without the requirement of the radionuclide exiting from the nanoparticle. With this approach, very high doses of radiation can be delivered to solid tumors while sparing normal organs. Recent technological developments in image-guidance, convection enhanced delivery and newly developed nanoparticles carrying beta-emitting radionuclides will be reviewed. Examples will be shown describing how this new approach has promise for the treatment of brain, head and neck, and other types of solid tumors.
当前癌症治疗的主要局限之一是，使用传统静脉给药方式无法将杀肿瘤药物送达整个肿瘤组织。利用先进图像引导递送的携带发射β射线治疗性放射性核素的纳米颗粒，在改善实体肿瘤治疗方面具有巨大潜力。将图像引导与纳米颗粒载体相结合，可以提高局部辐射对肿瘤的递送效果。标记有某些发射β射线放射性核素的纳米颗粒本质上是诊疗剂，能够提供有关肿瘤和体内分布及局部剂量测定的信息。图像引导热疗可使静脉内纳米颗粒在肿瘤内的摄取增加，从而改善治疗效果。此外，纳米颗粒是通过对流增强递送直接向肿瘤内输注发射β射线放射性核素的理想载体，可在不要求放射性核素从纳米颗粒中逸出的情况下实现局部治疗性辐射的递送。通过这种方法，可以在保护正常器官的同时，将非常高剂量的辐射传递给实体肿瘤。本文将综述图像引导、对流增强递送以及新开发的携带发射β射线放射性核素的纳米颗粒等方面的最新技术进展。将展示一些实例，说明这种新方法在治疗脑、头颈部及其他类型实体肿瘤方面的前景。
