The release of cytotoxic drugs from acrylic bone cement.

The ability of cis-platinum, 5-fluorouracil, and methotrexate to leach out from various types of bone cements was examined in three different experimental systems: (1) in vitro release in physiological solution; (2) in vitro release in the presence of mouse fibrosarcoma cells; and (3) in vivo release in rabbits. The amount of drugs released was measured either spectrophotometrically by atomic absorption or by using tritium-labeled drugs. In vitro cement pellets were found to release these drugs slowly for up to six months; release was greater in the first few days, rapidly declining with time. Up to 6% of the methotrexate implanted leached out during the entire experiment. The figures for cis-platinum and 5-fluorouracil were much less: 3.3% and 3.4%, respectively. Palacos bone cement had the best leaching properties. The drugs leached out were also effective in reducing the numbers of viable mouse fibrosarcoma cells in tissue culture. In vivo, high levels of the drugs were recovered from blood drained from the operative wound of the rabbits, while very low levels of these drugs were found in the serum. Anticancer drug-loaded cement may be used effectively in the treatment of pathologic fractures and tumor surgery. This delivery method may reduce the side effects that result from systemic administration of such drugs.