Khosrawipour Veria, Mikolajczyk Agata, Paslawski Robert, Plociennik Michal, Nowak Kacper, Kulas Joanna, Arafkas Mohamed, Khosrawipour Tanja
Division of Colorectal Surgery, Department of Surgery, University of California, Irvine, CA 92868, USA.
Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland.
Mol Clin Oncol. 2020 Apr;12(4):350-354. doi: 10.3892/mco.2020.1999. Epub 2020 Feb 18.
Pressurized intrathoracic aerosol chemotherapy (PITAC) has been introduced to the clinical setting as a novel treatment option for pleural metastasis (PM). For decades the therapeutic application of aerosols was limited to intrabronchial delivery. However, present studies suggest performing PITAC on patients with PM and malignant pleural effusion. Using an established swine model, the present study aimed to introduce a facilitated intrathoracic chemoaerosol application via spray-catheter. Using an ex-vivo model of 3 postmortem swine, the feasibility of intrathoracic aerosol chemotherapy (ITC) with doxorubicin using a spray-catheter was evaluated in a normal pressure environment. Following thoracotomy, the spray-catheter was inserted via trocar. Tissue samples were retrieved and further analyzed by fluorescence microscopy to detect doxorubicin contact. Our data demonstrated that the application of ITC was technically feasible and did not exhibit any significant obstacles. By making a minimally invasive thoracotomy incision it was possible to create an adequate pneumothorax without the need of a double-lumen tube or intubation. ITC did not require the creation of a pressurized environment. Tissue samples revealed doxorubicin contact within the pleura. In conclusion, ITC is a fast and feasible procedure that could possibly be administered via bedside application, therefore eliminating the need of an operating room and surgical staff. However, further studies are required to evaluate the safety of patients and physicians regarding this novel applicational modality. Nevertheless, the present study demonstrated that ITC may potentially be applied at bedside, an option that is particularly important for patients who do not qualify for PITAC procedures.
压力式胸腔内气溶胶化疗（PITAC）已作为一种治疗胸膜转移（PM）的新型治疗方法引入临床。几十年来，气溶胶的治疗应用仅限于支气管内给药。然而，目前的研究表明，可对胸膜转移和恶性胸腔积液患者进行PITAC治疗。本研究利用已建立的猪模型，旨在通过喷雾导管实现一种简便的胸腔内化疗气溶胶给药方法。利用3只死后猪的离体模型，在常压环境下评估了使用喷雾导管进行阿霉素胸腔内气溶胶化疗（ITC）的可行性。开胸后，通过套管针插入喷雾导管。获取组织样本并通过荧光显微镜进一步分析以检测阿霉素接触情况。我们的数据表明，ITC给药在技术上是可行的，且未显示出任何重大障碍。通过做一个微创开胸切口，无需双腔管或插管即可造成足够的气胸。ITC不需要建立加压环境。组织样本显示胸膜内有阿霉素接触。总之，ITC是一种快速且可行的操作，可能可以在床边进行，因此无需手术室和外科工作人员。然而，需要进一步研究来评估这种新型给药方式对患者和医生的安全性。尽管如此，本研究表明ITC可能可以在床边应用，这一选择对不符合PITAC治疗程序的患者尤为重要。
