Zucal Isabel, Geis Sebastian, Prantl Lukas, Haerteis Silke, Aung Thiha
Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University Clinic of Regensburg, 93053 Regensburg, Germany.
Institute for Molecular and Cellular Anatomy, University of Regensburg, 93053 Regensburg, Germany.
J Pers Med. 2021 Nov 5;11(11):1152. doi: 10.3390/jpm11111152.
Sarcomas are characterized by a high metastatic potential and aggressive growth. Despite surgery, chemotherapy plays an important role in the treatment of these tumors. Optimal anti-cancer therapy with maximized local efficacy and minimized systemic side effects has been the object of many studies for a long time. To improve the local efficacy of anti-tumor therapy, isolated limb perfusion with high-dose cytostatic agents has been introduced in surgical oncology. In order to control the local distribution of substances, radiolabeled cytostatic drugs or perfusion solutions have been applied but often require the presence of specialized personnel and result in a certain exposure to radiation. In this study, we present a novel strategy using indocyanine green to track tumor perfusion with high-dose cytostatic therapy. In a rat cadaver model, the femoral vessels were cannulated and connected to a peristaltic pump to provide circulation within the selected limb. The perfusion solution contained indocyanine green and high-dose doxorubicin. An infrared camera enabled the visualization of indocyanine green during limb perfusion, and subsequent leakage control was successfully performed. Histologic analysis of sections derived proximally from the injection site excluded systemic drug dispersion. In this study, the application of indocyanine green was proven to be a safe and cost- and time-efficient method for precise leakage control in isolated limb perfusion with a high-dose cytostatic agent.
肉瘤具有高转移潜能和侵袭性生长的特点。尽管有手术治疗，但化疗在这些肿瘤的治疗中仍起着重要作用。长期以来，以最大化局部疗效和最小化全身副作用为目标的最佳抗癌治疗一直是许多研究的对象。为了提高抗肿瘤治疗的局部疗效，外科肿瘤学中引入了高剂量细胞毒性药物的离体肢体灌注。为了控制物质的局部分布，已应用放射性标记的细胞毒性药物或灌注溶液，但通常需要专业人员在场，并且会导致一定的辐射暴露。在本研究中，我们提出了一种使用吲哚菁绿来追踪高剂量细胞毒性治疗中肿瘤灌注的新策略。在大鼠尸体模型中，将股血管插管并连接到蠕动泵，以在选定的肢体中提供循环。灌注溶液含有吲哚菁绿和高剂量阿霉素。红外摄像机能够在肢体灌注期间可视化吲哚菁绿，并成功进行了后续的渗漏控制。对注射部位近端切片的组织学分析排除了全身药物扩散。在本研究中，吲哚菁绿的应用被证明是一种安全、经济且省时的方法，可用于高剂量细胞毒性药物离体肢体灌注中的精确渗漏控制。
