Harris Jamie C, Coburn Jeannine M, Kajdacsy-Balla Andre, Kaplan David L, Chiu Bill
Department of Surgery, Rush University Medical Center, 1750 W. Harrison St, Suite 785, Chicago, IL, 60612, USA.
Department of Biomedical Engineering, Tufts University, 4 Colby Street, Medford, MA, 02155, USA.
J Pediatr Surg. 2016 Dec;51(12):2058-2062. doi: 10.1016/j.jpedsurg.2016.09.040. Epub 2016 Sep 16.
Sarcoma accounts for 20% of solid tumors in children. Surgery has significant morbidity. We hypothesized that delivering chemotherapy directly into tumors through sustained release silk systems could slow tumor growth.
Human Ewing sarcoma cells A673 were cultured with vincristine and doxorubicin to determine half maximal inhibitory concentration (IC). Cells were injected into mouse hind leg to create orthotopic tumors. Tumor volumes were measured using ultrasound. When volume reached >250mm interventions included: implantation of drug-free silk foam (Control-F), doxorubicin 400μg foam (Dox400-F), vincristine 50μg foam (Vin50-F), drug-free silk gel (Control-G), vincristine 50μg gel (Vin50-G), or single dose intravenous vincristine 50μg (Vin50-IV). End-point was volume>1000mm. Kaplan Meier and ANOVA were used.
IC for vincristine and doxorubicin was 0.5ng/mL and 200ng/mL, respectively. There was no difference between Dox400-F [6±1days to end point (DTEP)] and Control-F (5±1.3 DTEP). Vin50-F (12.4±3.5 DTEP) had slower growth compared to Control-F (p<0.001), and there was no difference between Vin50-F and Vin50-IV (14±0 DTEP). Growth was slowest with Vin50-G, 28±10.3 DTEP compared to all other treatment groups (p<0.05).
Sustained delivery of vincristine inside the sarcoma tumor with silk gel decreased tumor growth. Applying this intratumoral treatment strategy may potentially decrease the extent of surgical excision.
肉瘤占儿童实体瘤的20%。手术具有显著的发病率。我们假设通过缓释丝素系统将化疗药物直接输送到肿瘤中可以减缓肿瘤生长。
将人尤因肉瘤细胞A673与长春新碱和阿霉素一起培养以确定半数最大抑制浓度(IC)。将细胞注射到小鼠后腿以形成原位肿瘤。使用超声测量肿瘤体积。当体积达到>250mm时,干预措施包括:植入不含药物的丝素泡沫(对照-F)、400μg阿霉素泡沫(Dox400-F)、50μg长春新碱泡沫(Vin50-F)、不含药物的丝素凝胶(对照-G)、50μg长春新碱凝胶(Vin50-G)或单次静脉注射50μg长春新碱(Vin50-IV)。终点是体积>1000mm。使用Kaplan Meier和方差分析。
长春新碱和阿霉素的IC分别为0.5ng/mL和200ng/mL。Dox400-F[至终点的天数(DTEP)为6±1天]与对照-F(5±1.3 DTEP)之间没有差异。与对照-F相比,Vin50-F(12.4±3.5 DTEP)生长较慢(p<0.001),并且Vin50-F与Vin50-IV(14±0 DTEP)之间没有差异。Vin50-G生长最慢,与所有其他治疗组相比,DTEP为28±10.3天(p<0.05)。
用丝素凝胶在肉瘤肿瘤内持续递送长春新碱可减缓肿瘤生长。应用这种瘤内治疗策略可能会潜在地减少手术切除范围。