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化疗药物经增强脑转移瘤内的对流输送。

Convection enhanced delivery of chemotherapeutic drugs into brain tumour.

机构信息

Department of Mechanical Engineering, Imperial College London, South Kensington Campus, London, United Kingdom.

Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore.

出版信息

J Control Release. 2018 Feb 10;271:74-87. doi: 10.1016/j.jconrel.2017.12.020. Epub 2017 Dec 20.

Abstract

Convection enhanced delivery (CED) of chemotherapeutic drugs can successfully bypass the blood-brain barrier (BBB). However, the treatment efficacy is significantly variable in clinic owing to the absence of proper drugs and the lack of understanding on the local drug transport. In this study, mathematical modelling is employed to investigate the suitability of six chemotherapeutic drugs from the perspective of intratumoural transport, including fluorouracil, carmustine, cisplatin, methotrexate, doxorubicin and paclitaxel. The convection/diffusion/reaction model coupled with Darcy's law is applied to a 3-D realistic brain tumour model that is extracted from magnetic resonance (MR) images. The modelling demonstrates the advantages of CED in enhancing the convective flow of interstitial fluid and reducing the drug concentration dilution caused by the fluid loss from blood stream in the tumour region around the infusion site. The delivery outcomes of the drug in CED treatments are strongly dependent on its physicochemical properties. Convection is more effective in determining the transport of paclitaxel and methotrexate in brain tumour. Paclitaxel exhibits its superiority in drug penetration and accumulation, resulting in the largest effective delivery volume as compared to the other studied drugs. Nanocarrier and diagnostic ultrasound are able to enhance the drug penetration for achieving improved delivery outcomes. Results obtained in this study can serve as a guide for optimising CED treatment regimens.

摘要

通过对流增强式(CED)输送化疗药物可以成功绕过血脑屏障(BBB)。然而,由于缺乏合适的药物和对局部药物输送的缺乏了解,临床治疗效果差异显著。在这项研究中,我们采用数学建模方法,从肿瘤内输送的角度研究了氟尿嘧啶、卡莫司汀、顺铂、甲氨蝶呤、阿霉素和紫杉醇等六种化疗药物的适用性。该模型将对流/扩散/反应模型与达西定律相结合,应用于从磁共振(MR)图像提取的 3D 真实脑肿瘤模型。建模结果表明,CED 可以增强间质液的对流,减少因输注部位附近肿瘤区域血流中液体流失而导致的药物浓度稀释,从而提高药物输送效果。CED 治疗中药物的输送效果强烈依赖于其物理化学性质。对流在决定脑肿瘤中紫杉醇和甲氨蝶呤的输送方面更为有效。与其他研究药物相比,紫杉醇在药物渗透和积累方面表现出优势,从而实现了最大的有效输送体积。纳米载体和诊断性超声能够增强药物渗透,从而实现更好的输送效果。本研究结果可为优化 CED 治疗方案提供指导。

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