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双相微秒脉冲爆发抑制肿瘤生长。

Bursts of Bipolar Microsecond Pulses Inhibit Tumor Growth.

作者信息

Sano Michael B, Arena Christopher B, Bittleman Katelyn R, DeWitt Matthew R, Cho Hyung J, Szot Christopher S, Saur Dieter, Cissell James M, Robertson John, Lee Yong W, Davalos Rafael V

机构信息

School of Biomedical Engineering and Sciences, Virginia Tech, USA.

Department of Radiation Oncology, Division of Radiation Physics, Stanford University, USA.

出版信息

Sci Rep. 2015 Oct 13;5:14999. doi: 10.1038/srep14999.

Abstract

Irreversible electroporation (IRE) is an emerging focal therapy which is demonstrating utility in the treatment of unresectable tumors where thermal ablation techniques are contraindicated. IRE uses ultra-short duration, high-intensity monopolar pulsed electric fields to permanently disrupt cell membranes within a well-defined volume. Though preliminary clinical results for IRE are promising, implementing IRE can be challenging due to the heterogeneous nature of tumor tissue and the unintended induction of muscle contractions. High-frequency IRE (H-FIRE), a new treatment modality which replaces the monopolar IRE pulses with a burst of bipolar pulses, has the potential to resolve these clinical challenges. We explored the pulse-duration space between 250 ns and 100 μs and determined the lethal electric field intensity for specific H-FIRE protocols using a 3D tumor mimic. Murine tumors were exposed to 120 bursts, each energized for 100 μs, containing individual pulses 1, 2, or 5 μs in duration. Tumor growth was significantly inhibited and all protocols were able to achieve complete regressions. The H-FIRE protocol substantially reduces muscle contractions and the therapy can be delivered without the need for a neuromuscular blockade. This work shows the potential for H-FIRE to be used as a focal therapy and merits its investigation in larger pre-clinical models.

摘要

不可逆电穿孔(IRE)是一种新兴的局部治疗方法,已在热消融技术禁忌的不可切除肿瘤治疗中显示出应用价值。IRE使用超短持续时间、高强度的单极脉冲电场来永久性破坏特定体积内的细胞膜。尽管IRE的初步临床结果很有前景,但由于肿瘤组织的异质性以及意外诱发肌肉收缩,实施IRE可能具有挑战性。高频IRE(H-FIRE)是一种新的治疗方式,用一串双极脉冲取代单极IRE脉冲,有可能解决这些临床挑战。我们探索了250纳秒至100微秒之间的脉冲持续时间范围,并使用三维肿瘤模型确定了特定H-FIRE方案的致死电场强度。将小鼠肿瘤暴露于120串脉冲下,每串脉冲持续100微秒,包含持续时间为1、2或5微秒的单个脉冲。肿瘤生长受到显著抑制,所有方案均能实现完全消退。H-FIRE方案可大幅减少肌肉收缩,且无需神经肌肉阻滞剂即可进行治疗。这项研究表明H-FIRE作为一种局部治疗方法具有潜力,值得在更大的临床前模型中进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af60/4602310/cc85f8af738e/srep14999-f1.jpg

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