Sridharan Vijayalakshmi, Thomas Chanice J, Cao Maohua, Melnyk Stepan B, Pavliv Oleksandra, Joseph Jacob, Singh Sharda P, Sharma Sunil, Moros Eduardo G, Boerma Marjan
University of Arkansas for Medical Sciences, Department of Pharmaceutical Sciences, Division of Radiation Health, Little Rock, United States.
Oakwood University, Huntsville, United States.
Radiother Oncol. 2016 May;119(2):259-64. doi: 10.1016/j.radonc.2016.03.027. Epub 2016 Apr 9.
Thoracic (chemo)radiation therapy is increasingly administered with tyrosine kinase inhibitors (TKI). While TKI have adverse effects on the heart, it is unknown whether combination with other cancer therapies causes enhanced toxicity. We used an animal model to investigate whether radiation and sunitinib interact in their effects on the heart.
Male Sprague-Dawley rats received local heart irradiation (9Gy per day, 5days). Oral sunitinib (8 or 15mg/kg bodyweight per day) started on day 1 of irradiation and continued for 2weeks. Cardiac function was examined with echocardiography. Cardiac remodeling, cell death, left ventricular (LV) oxidative stress markers, mitochondrial morphology and mitochondrial permeability transition pore (mPTP) opening were assessed.
Cardiac diameter, stroke volume, and LV volume, mass and anterior wall thickness increased in time, but only in the vehicle group. Sunitinib reduced LV inner diameter and volume in systole, which were counteracted by radiation. Sunitinib and radiation showed enhanced effects on mitochondrial morphology and mPTP opening, but not on cardiac troponin I, mast cell numbers or markers of oxidative stress.
This study found no early enhanced effects of radiation and sunitinib on cardiac function or structure. Long-term effects remain to be determined.
胸段(化疗)放疗越来越多地与酪氨酸激酶抑制剂(TKI)联合使用。虽然TKI对心脏有不良影响,但与其他癌症治疗方法联合使用是否会增加毒性尚不清楚。我们使用动物模型来研究放疗与舒尼替尼对心脏的影响是否相互作用。
雄性Sprague-Dawley大鼠接受局部心脏照射(每天9Gy,共5天)。口服舒尼替尼(每天8或15mg/kg体重)于照射第1天开始,持续2周。用超声心动图检查心脏功能。评估心脏重塑、细胞死亡、左心室(LV)氧化应激标志物、线粒体形态和线粒体通透性转换孔(mPTP)开放情况。
心脏直径、每搏输出量、左心室容积、质量和前壁厚度随时间增加,但仅在对照组中出现。舒尼替尼可降低收缩期左心室内径和容积,但放疗可抵消这一作用。舒尼替尼和放疗对线粒体形态和mPTP开放有增强作用,但对心肌肌钙蛋白I、肥大细胞数量或氧化应激标志物无影响。
本研究未发现放疗与舒尼替尼对心脏功能或结构有早期增强作用。长期影响仍有待确定。