Menei P, Boisdron-Celle M, Croué A, Guy G, Benoit J P
Service de Neurochirurgie, Centre Hospitalo-Universitaire, Angers, France.
Neurosurgery. 1996 Jul;39(1):117-23; discussion 123-4. doi: 10.1097/00006123-199607000-00023.
Poly(lactic acid-co-glycolic acid) (PLAGA) microspheres are promising systems for interstitial chemotherapy of brain tumors. They can be readily implanted by stereotaxy and are biocompatible with the brain, in which they are totally biodegraded within 2 months. 5-Fluorouracil (5-FU) was selected for encapsulation, because this hydrophilic and antimetabolic drug is not directly neurotoxic and does not readily cross the blood-brain barrier. Also, its anticancer activity may be improved by sustained administration. Furthermore, it is a potent radiosensitizer.
To study their fate and toxicity, two types of 5-FU-loaded PLAGA microspheres were implanted in healthy rats by stereotaxy. One type presented a fast in vitro release profile (FR), and the second exhibited a slow in vitro release pattern (SR) (100% of the encapsulated 5-FU is released within 72 hours and 18 days, respectively). Periodically, rats were killed for microscopic examination. The efficacy of these microspheres on rat glioma was then evaluated. Seven days after stereotactic implantation of C6 malignant glioma cells in the brain, the rats were treated by intratumoral injection of 5-FU solution, blank microspheres, or 5-FU-loaded microspheres (FR and SR types). The mortality of these treated groups was compared by the log-rank test with that of an untreated group.
After implantation of two types of 5-FU-loaded PLAGA microspheres, no sign of clinical or histological toxicity was observed. Entrapped 5-FU crystals were observed until Days 12 and 20 postimplantation within FR and SR microspheres, respectively, which suggests a longer releasing period in vivo than in vitro. In the therapeutic evaluation, only intratumoral implantation of SR-type 5-FU-loaded microspheres significantly decreased the mortality (P = 0.017).
5-FU-loaded PLAGA microspheres were implanted in rat brains without evident toxicity. Histological examination suggested a longer sustained delivery period in vivo than in vitro. Intratumoral implantation of SR-type 5-FU-loaded microspheres decreased the mortality of C6 tumor-bearing rats. This effect can be related to the local and the sustained delivery of the drug, because 5-FU administered systemically is ineffective against brain tumors.
聚乳酸-乙醇酸共聚物(PLAGA)微球是用于脑肿瘤间质化疗的有前景的体系。它们可通过立体定向容易地植入,并且与脑具有生物相容性,在脑中它们在2个月内完全生物降解。选择5-氟尿嘧啶(5-FU)进行包封,因为这种亲水性抗代谢药物不具有直接神经毒性且不易穿过血脑屏障。此外,持续给药可能会提高其抗癌活性。而且,它是一种有效的放射增敏剂。
为了研究它们的转归和毒性,通过立体定向将两种类型的载5-FU的PLAGA微球植入健康大鼠体内。一种类型呈现快速的体外释放曲线(FR),另一种呈现缓慢的体外释放模式(SR)(分别在72小时和18天内释放100%的包封5-FU)。定期处死大鼠进行显微镜检查。然后评估这些微球对大鼠胶质瘤的疗效。在脑内立体定向植入C6恶性胶质瘤细胞7天后,通过瘤内注射5-FU溶液、空白微球或载5-FU微球(FR型和SR型)对大鼠进行治疗。通过对数秩检验比较这些治疗组与未治疗组的死亡率。
植入两种类型的载5-FU的PLAGA微球后,未观察到临床或组织学毒性迹象。分别在FR和SR微球植入后第12天和第20天观察到包封的5-FU晶体,这表明其体内释放期比体外更长。在治疗评估中,只有瘤内植入SR型载5-FU微球显著降低了死亡率(P = 0.017)。
载5-FU的PLAGA微球植入大鼠脑内无明显毒性。组织学检查表明其体内持续递送期比体外更长。瘤内植入SR型载5-FU微球降低了荷C6肿瘤大鼠的死亡率。这种效应可能与药物的局部和持续递送有关,因为全身给药的5-FU对脑肿瘤无效。