1
|
Yang S, Mu C, Liu T, Pei P, Shen W, Zhang Y, Wang G, Chen L, Yang K. Radionuclide-Labeled Microspheres for Radio-Immunotherapy of Hepatocellular Carcinoma. Adv Healthc Mater 2023; 12:e2300944. [PMID: 37235739 DOI: 10.1002/adhm.202300944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/24/2023] [Indexed: 05/28/2023]
Abstract
Brachytherapy, including radioactive seed implantation (RSI) and transarterial radiation therapy embolization (TARE), is an important treatment modality for advanced hepatocellular carcinoma (HCC), but the inability of RSI and TARE to treat tumor metastasis and recurrence limits their benefits for patients in the clinic. Herein, indoleamine 2,3-dioxygenase 1 (IDO1) inhibitors-loaded alginate microspheres (IMs) are developed as radionuclide carriers with immunomodulatory functions to achieve effective radio-immunotherapy. The size and swelling properties of IMs can be facilely tailored by adjusting the calcium source during emulsification. Small/large IMs(SIMs/LIMs) are biocompatible and available for RSI and TARE, respectively, after 177 Lu labeling. Among them, 177 Lu-SIMs completely eliminated subcutaneous HCC in mice after intratumoral RSI. Moreover, in combination with anti-PD-L1, 177 Lu-SIMs not only eradicate primary tumors by RSI but also effectively inhibit the growth of distant tumors, wherein the potent abscopal effect can be ascribed to the immune stimulation of RSI and the modulation of the tumor immune microenvironment (TIME) by IDO1 inhibitors. In parallel, LIMs demonstrate excellent embolization efficiency, resulting in visible necrotic lesions in the central auricular artery of rabbits, which are promising for TARE in future studies. Collectively, a versatile therapeutic agent is provided to synchronously modulate the TIME during brachytherapy for efficient radio-immunotherapy of advanced HCC.
Collapse
Affiliation(s)
- Sai Yang
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection & School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, 215123, P. R. China
| | - Chongjing Mu
- Invasive Technology Department, The Affiliated Suzhou Hospital of Nanjing Medical University, Jiangsu, Suzhou, 215101, P. R. China
| | - Teng Liu
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection & School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, 215123, P. R. China
| | - Pei Pei
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection & School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, 215123, P. R. China
| | - Wenhao Shen
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection & School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, 215123, P. R. China
| | - Yanxiang Zhang
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection & School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, 215123, P. R. China
| | - Guanglin Wang
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection & School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, 215123, P. R. China
| | - Lei Chen
- Invasive Technology Department, The Affiliated Suzhou Hospital of Nanjing Medical University, Jiangsu, Suzhou, 215101, P. R. China
| | - Kai Yang
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection & School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, 215123, P. R. China
| |
Collapse
|
2
|
Javed MS, Zubair M, Rizwan K, Jamil M. In Vitro Anti-Microbial Activity and Anti-Cancer Potential of Novel Synthesized Carbamothioyl-Furan-2-Carboxamide Derivatives. Molecules 2023; 28:4583. [PMID: 37375137 DOI: 10.3390/molecules28124583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
A series of carbamothioyl-furan-2-carboxamide derivatives were synthesized using a one-pot strategy. Compounds were obtained in moderate to excellent yields (56-85%). Synthesized derivatives were evaluated for their anti-cancer (HepG2, Huh-7, and MCF-7 human cancer cell lines) and anti-microbial potential. Compound p-tolylcarbamothioyl)furan-2-carboxamide showed the highest anti-cancer activity at a concentration of 20 μg/mL against hepatocellular carcinoma, with a cell viability of 33.29%. All compounds showed significant anti-cancer activity against HepG2, Huh-7, and MCF-7, while indazole and 2,4-dinitrophenyl containing carboxamide derivatives were found to be less potent against all tested cell lines. Results were compared with the standard drug doxorubicin. Carboxamide derivatives possessing 2,4-dinitrophenyl showed significant inhibition against all bacterial and fungal strains with inhibition zones (I.Z) in the range of 9-17 and MICs were found to be 150.7-295 μg/mL. All carboxamide derivatives showed significant anti-fungal activity against all tested fungal strains. Gentamicin was used as the standard drug. The results showed that carbamothioyl-furan-2-carboxamide derivatives could be a potential source of anti-cancer and anti-microbial agents.
Collapse
Affiliation(s)
- Muhammad Salman Javed
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Muhammad Zubair
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Komal Rizwan
- Department of Chemistry, University of Sahiwal, Sahiwal 57000, Pakistan
| | - Muhammad Jamil
- Department of Chemistry, Government Post Graduate College, Sahiwal 57000, Pakistan
| |
Collapse
|
3
|
Nuez-Martínez M, Queralt-Martín M, Muñoz-Juan A, Aguilella VM, Laromaine A, Teixidor F, Viñas C, Pinto CG, Pinheiro T, Guerreiro JF, Mendes F, Roma-Rodrigues C, Baptista PV, Fernandes AR, Valic S, Marques F. Boron clusters (ferrabisdicarbollides) shaping the future as radiosensitizers for multimodal (chemo/radio/PBFR) therapy of glioblastoma. J Mater Chem B 2022; 10:9794-9815. [PMID: 36373493 DOI: 10.1039/d2tb01818g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Glioblastoma multiforme (GBM) is the most common and fatal primary brain tumor, and is highly resistant to conventional radiotherapy and chemotherapy. Therefore, the development of multidrug resistance and tumor recurrence are frequent. Given the poor survival with the current treatments, new therapeutic strategies are urgently needed. Radiotherapy (RT) is a common cancer treatment modality for GBM. However, there is still a need to improve RT efficiency, while reducing the severe side effects. Radiosensitizers can enhance the killing effect on tumor cells with less side effects on healthy tissues. Herein, we present our pioneering study on the highly stable and amphiphilic metallacarboranes, ferrabis(dicarbollides) ([o-FESAN]- and [8,8'-I2-o-FESAN]-), as potential radiosensitizers for GBM radiotherapy. We propose radiation methodologies that utilize secondary radiation emissions from iodine and iron, using ferrabis(dicarbollides) as iodine/iron donors, aiming to achieve a greater therapeutic effect than that of a conventional radiotherapy. As a proof-of-concept, we show that using 2D and 3D models of U87 cells, the cellular viability and survival were reduced using this treatment approach. We also tested for the first time the proton boron fusion reaction (PBFR) with ferrabis(dicarbollides), taking advantage of their high boron (11B) content. The results from the cellular damage response obtained suggest that proton boron fusion radiation therapy, when combined with boron-rich compounds, is a promising modality to fight against resistant tumors. Although these results are encouraging, more developments are needed to further explore ferrabis(dicarbollides) as radiosensitizers towards a positive impact on the therapeutic strategies for GBM.
Collapse
Affiliation(s)
- Miquel Nuez-Martínez
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
| | - María Queralt-Martín
- Laboratory of Molecular Biophysics, Department of Physics, Universitat Jaume I, 12071 Castelló, Spain
| | - Amanda Muñoz-Juan
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
| | - Vicente M Aguilella
- Laboratory of Molecular Biophysics, Department of Physics, Universitat Jaume I, 12071 Castelló, Spain
| | - Anna Laromaine
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
| | - Francesc Teixidor
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
| | - Clara Viñas
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
| | - Catarina G Pinto
- Centro de Ciências e Tecnologias Nucleares and Departamento de Engenharia e Ciências Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, 2695-066 Bobadela LRS, Portugal.
| | - Teresa Pinheiro
- iBB - Instituto de Bioengenharia e Biociências, Departamento de Engenharia e Ciências Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal
| | - Joana F Guerreiro
- Centro de Ciências e Tecnologias Nucleares and Departamento de Engenharia e Ciências Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, 2695-066 Bobadela LRS, Portugal.
| | - Filipa Mendes
- Centro de Ciências e Tecnologias Nucleares and Departamento de Engenharia e Ciências Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, 2695-066 Bobadela LRS, Portugal.
| | - Catarina Roma-Rodrigues
- UCIBIO - Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal
| | - Pedro V Baptista
- UCIBIO - Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal
| | - Alexandra R Fernandes
- UCIBIO - Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal
| | - Srecko Valic
- Ruđer Bošković Institute, Bijenička 54, HR-10000 Zagreb, Croatia
| | - Fernanda Marques
- Centro de Ciências e Tecnologias Nucleares and Departamento de Engenharia e Ciências Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, 2695-066 Bobadela LRS, Portugal.
| |
Collapse
|
4
|
Liu R, Li H, Qiu Y, Liu H, Cheng Z. Recent Advances in Hepatocellular Carcinoma Treatment with Radionuclides. Pharmaceuticals (Basel) 2022; 15:1339. [PMID: 36355512 PMCID: PMC9694760 DOI: 10.3390/ph15111339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 06/20/2024] Open
Abstract
As the third leading cause of cancer death worldwide, hepatocellular carcinoma (HCC) is characterized by late detection, difficult diagnosis and treatment, rapid progression, and poor prognosis. Current treatments for liver cancer include surgical resection, radiofrequency ablation, liver transplantation, chemotherapy, external radiation therapy, and internal radionuclide therapy. Radionuclide therapy is the use of high-energy radiation emitted by radionuclides to eradicate tumor cells, thus achieving the therapeutic effect. Recently, with the continuous development of biomedical technology, the application of radionuclides in treatment of HCC has progressed steadily. This review focuses on three types of radionuclide-based treatment regimens, including transarterial radioembolization (TARE), radioactive seed implantation, and radioimmunotherapy. Their research progress and clinical applications are summarized. The advantages, limitations, and clinical potential of radionuclide treatment of HCC are discussed.
Collapse
Affiliation(s)
- Ruiqi Liu
- Institute of Molecular Medicine, College of Life and Health Sciences, Northeastern University, Shenyang 110000, China
| | - Hong Li
- Institute of Molecular Medicine, College of Life and Health Sciences, Northeastern University, Shenyang 110000, China
| | - Yihua Qiu
- Institute of Molecular Medicine, College of Life and Health Sciences, Northeastern University, Shenyang 110000, China
| | - Hongguang Liu
- Institute of Molecular Medicine, College of Life and Health Sciences, Northeastern University, Shenyang 110000, China
| | - Zhen Cheng
- State Key Laboratory of Drug Research, Molecular Imaging Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- Shandong Laboratory of Yantai Drug Discovery, Bohai Rim Advanced Research Institute for Drug Discovery, Yantai 264117, China
| |
Collapse
|
5
|
Delaney LJ, Tantawi M, Wessner CE, Machado P, Forsberg F, Lyshchik A, O'Kane P, Liu JB, Civan J, Tan A, Anton K, Shaw CM, Eisenbrey JR. Predicting Long-Term Hepatocellular Carcinoma Response to Transarterial Radioembolization Using Contrast-Enhanced Ultrasound: Initial Experiences. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2523-2531. [PMID: 34130880 PMCID: PMC8355136 DOI: 10.1016/j.ultrasmedbio.2021.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/26/2021] [Accepted: 05/06/2021] [Indexed: 05/12/2023]
Abstract
Conventional cross-sectional imaging done shortly after radioembolization of hepatocellular carcinoma (HCC) does not reliably predict long-term response to treatment. This study evaluated whether quantitative contrast-enhanced ultrasound (CEUS) can predict the long-term response of HCC to yttrium-90 (Y-90) treatment. Fifteen patients underwent CEUS at three time points: immediately following treatment and 1 and 2 wk post-treatment. Response 3-6 mo after treatment was categorized on contrast-enhanced magnetic resonance imaging by two experienced radiologists using the Modified Response Evaluation Criteria in Solid Tumors. CEUS data were analyzed by quantifying tumor perfusion and residual fractional vascularity using time-intensity curves. Patients with stable disease on magnetic resonance imaging had significantly greater fractional vascularity 2 wk post-treatment (65.15%) than those with partial or complete response (13.8 ± 9.9%, p = 0.007, and 14.9 ± 15.4%, p = 0.009, respectively). Complete responders had lower tumor vascularity at 2 wk than at post-operative examination (-38.3 ± 15.4%, p = 0.045). Thus, this pilot study suggests CEUS may provide an earlier indication of Y-90 treatment response than cross-sectional imaging.
Collapse
Affiliation(s)
- Lauren J Delaney
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mohamed Tantawi
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Corinne E Wessner
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Priscilla Machado
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Flemming Forsberg
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Patrick O'Kane
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ji-Bin Liu
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jesse Civan
- Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Allison Tan
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Kevin Anton
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Colette M Shaw
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
| |
Collapse
|
6
|
Eisenbrey JR, Gabriel H, Savsani E, Lyshchik A. Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies. Abdom Radiol (NY) 2021; 46:3579-3595. [PMID: 33825927 DOI: 10.1007/s00261-021-03059-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 02/06/2023]
Abstract
Hepatocellular carcinoma (HCC) is a global problem constituting the second leading cause of cancer deaths worldwide, thereby necessitating an accurate and cost-effective solution for managing care. Ultrasound is well poised to address this need due to its low cost, portability, safety, and excellent temporal resolution. The role of ultrasound for HCC screening has been well established and supported by multiple international guidelines. Similarly, contrast-enhanced ultrasound (CEUS) can be used for the characterization of focal liver lesions in high-risk populations, and standardized criteria for CEUS have been established by the American College of Radiology Liver Imaging Reporting & Data System (LI-RADS). Following HCC identification, CEUS can also be highly beneficial in treatment planning, delivery, and monitoring HCC response to locoregional therapies. Specific advantages of CEUS include providing real-time treatment guidance and improved diagnostic performance for the detection of residual tumor viability or recurrence, thereby identifying patients in need of retreatment substantially earlier than contrast-enhanced CT and MRI. This review provides a primer on ultrasound and CEUS for the screening and characterization of HCC, with an emphasis on assessing tumor response to locoregional therapies.
Collapse
Affiliation(s)
- John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA.
| | - Helena Gabriel
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Esika Savsani
- Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA
| |
Collapse
|
7
|
Qian Y, Liu Q, Li P, Han Y, Zhang J, Xu J, Sun J, Wu A, Song S, Lu W. Highly Tumor-Specific and Long-Acting Iodine-131 Microbeads for Enhanced Treatment of Hepatocellular Carcinoma with Low-Dose Radio-Chemoembolization. ACS NANO 2021; 15:2933-2946. [PMID: 33529007 DOI: 10.1021/acsnano.0c09122] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Transarterial radioembolization (TARE) is considered the standard treatment for intermediate-stage hepatocellular carcinoma (HCC). Iodine-131 (131I)-labeled lipiodol TARE is an effective treatment for HCC but has been withdrawn due to its poor retention in tumor lesions and significant distribution in normal tissues with severe side effects. In this work, a highly tumor-specific 131I-TARE agent with long-time retention is developed by simply introducing tyrosine to poly(vinyl alcohol) (PVA) drug-eluting microbeads (Tyr-PVA-DEBs). The labeling efficiency of 131I-labeled microbeads remains above 85% in 50% serum for 31 days. Micro-single-photon emission computed tomography/computed tomography (μSPECT/CT) evidences that the 131I-labeled microbeads accumulate in the orthotopic N1S1 hepatoma of rats for 31 days following intra-arterial injection. The cumulative radiation dose per cubic centimeter of the tumor is at least 13 678-fold higher than that of normal tissues. The highly tumor-selective radiation of the 131I-labeled microbeads allows localized delivery of 345.04 ± 139.16 Gy to the tumor following a single injection dose as low as 0.2 mCi of 131I. Moreover, the 131I-labeled microbeads are loaded with doxorubicin hydrochloride (DOX) through the carboxy groups on tyrosine of the polymer. The 131I-DOX-loaded microbeads present a synergetic antitumor effect without recurrence in comparison with the microbeads labeled with 131I or loading DOX alone, attributed to the sensitization of DOX to 131I-induced ionizing radiation damage to DNA under the embolization-induced hypoxia. Our results demonstrate a high tumor retention of 131I-labeled embolic agent for low-dose transarterial radio-chemoembolization (TARCE) with a synergetic therapeutic effect on treating HCC, showing potential for clinical application.
Collapse
Affiliation(s)
- Yuyi Qian
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
| | - Qiufang Liu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Panli Li
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Yaobao Han
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215123, China
| | - Jianping Zhang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Jiaojiao Xu
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
| | - Jingwen Sun
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
| | - Aihua Wu
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
| | - Shaoli Song
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Wei Lu
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
| |
Collapse
|
8
|
Eisenbrey JR, Forsberg F, Wessner CE, Delaney LJ, Bradigan K, Gummadi S, Tantawi M, Lyshchik A, O'Kane P, Liu JB, Intenzo C, Civan J, Maley W, Keith SW, Anton K, Tan A, Smolock A, Shamimi-Noori S, Shaw CM. US-triggered Microbubble Destruction for Augmenting Hepatocellular Carcinoma Response to Transarterial Radioembolization: A Randomized Pilot Clinical Trial. Radiology 2020; 298:450-457. [PMID: 33320067 DOI: 10.1148/radiol.2020202321] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background US contrast agents are gas-filled microbubbles (MBs) that can be locally destroyed by using external US. Among other bioeffects, US-triggered MB destruction, also known as UTMD, has been shown to sensitize solid tumors to radiation in preclinical models through localized insult to the vascular endothelial cells. Purpose To evaluate the safety and preliminary efficacy of combining US-triggered MB destruction and transarterial radioembolization (TARE) in participants with hepatocellular carcinoma (HCC). Materials and Methods In this pilot clinical trial, participants with HCC scheduled for sublobar TARE were randomized to undergo either TARE or TARE with US-triggered MB destruction 1-4 hours and approximately 1 and 2 weeks after TARE. Enrollment took place between July 2017 and February 2020. Safety of US-triggered MB destruction was evaluated by physiologic monitoring, changes in liver function tests, adverse events, and radiopharmaceutical distribution. Treatment efficacy was evaluated by using modified Response Evaluation Criteria in Solid Tumors (mRECIST) on cross-sectional images, time to required next treatment, transplant rates, and overall survival. Differences across mRECIST reads were compared by using a Mann-Whitney U test, and the difference in prevalence of tumor response was evaluated by Fisher exact test, whereas differences in time to required next treatment and overall survival curves were compared by using a log-rank (Mantel-Cox) test. Results Safety results from 28 participants (mean age, 70 years ± 10 [standard deviation]; 17 men) demonstrated no significant changes in temperature (P = .31), heart rate (P = .92), diastolic pressure (P = .31), or systolic pressure (P = .06) before and after US-triggered MB destruction. No changes in liver function tests between treatment arms were observed 1 month after TARE (P > .15). Preliminary efficacy results showed a greater prevalence of tumor response (14 of 15 [93%; 95% CI: 68, 100] vs five of 10 [50%; 95% CI: 19, 81]; P = .02) in participants who underwent both US-triggered MB destruction and TARE (P = .02). Conclusion The combination of US-triggered microbubble destruction and transarterial radioembolization is feasible with an excellent safety profile in this patient population and appears to result in improved hepatocellular carcinoma treatment response. © RSNA, 2020.
Collapse
Affiliation(s)
- John R Eisenbrey
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Flemming Forsberg
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Corinne E Wessner
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Lauren J Delaney
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Kristen Bradigan
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Sriharsha Gummadi
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Mohamed Tantawi
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Andrej Lyshchik
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Patrick O'Kane
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Ji-Bin Liu
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Charles Intenzo
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Jesse Civan
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Warren Maley
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Scott W Keith
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Kevin Anton
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Allison Tan
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Amanda Smolock
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Susan Shamimi-Noori
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| | - Colette M Shaw
- From the Department of Radiology (J.R.E., F.F., C.E.W., L.J.D., K.B., S.G., M.T., A.L., P.O., J.B.L., C.I., K.A., A.T., A.S., S.S.N., C.M.S.), Department of Medicine, Division of Hepatology (J.C.), Department of Surgery (W.M.), and Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics (S.W.K.), Thomas Jefferson University, 132 S 10th St, 796E Main, Philadelphia, PA 19107; and Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.)
| |
Collapse
|
9
|
Pandey U, Subramanian S, Shaikh S, Gamre N, Kumar S, Dash A. Synthesis and Preliminary Biological Evaluation of 177Lu-Labeled Polyhydroxamic Acid Microparticles Toward Therapy of Hepatocellular Carcinoma. Cancer Biother Radiopharm 2019; 34:306-315. [PMID: 31188652 DOI: 10.1089/cbr.2018.2747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Transarterial radioembolization (TARE) represents an effective targeted therapeutic option for hepatocellular carcinoma (HCC), a cancer with high mortality and poor prognosis. The aim of this study was the preparation and preliminary biological evaluation of 177Lu-labeled polyhydroxamic acid (PHA) microparticles toward possible use in the therapy of HCC. Materials and Methods: PHA microparticles were synthesized starting from polyacrylamide. They were characterized by Fourier-transform infrared spectroscopy (FT-IR), visual color test, and laser diffraction particle size analysis. Experimental variables such as reaction pH, amount of PHA microparticles, carrier Lu content, and incubation time were optimized for maximum uptake of 177Lu on PHA microparticles. Stability of 177Lu-PHA microparticles was tested in the presence of competing Fe(III) ions in solution. In vitro stability of 177Lu-PHA microparticles was evaluated in 0.05 M sodium phosphate solution (pH 7.5), saline, and serum. Bioevaluation studies were performed in normal Wistar rats by intrahepatic artery injection of the 177Lu-PHA microparticles. Results: Successful synthesis of PHA microparticles could be confirmed from the results of FT-IR analysis and visual color test. Laser diffraction-based particle size analysis confirmed median particle size to be 54 μm, suitable for TARE. Under the optimized conditions, >99% loading of 177Lu on PHA microparticles could be achieved. Even in the presence of high concentration of Fe(III) ions, 177Lu binding to PHA microparticles was stable. 177Lu-PHA microparticles exhibited excellent in vitro stability in sodium phosphate solution, saline, and serum up to 5 d at 37°C. In the bioevaluation studies performed in normal Wistar rats, 92.8% ± 3.1% of 177Lu-PHA microparticles were retained in the liver at 96 h postinjection without any significant leakage to other organs. Conclusion: This preliminary study demonstrates the potential of synthesized PHA microparticles as carriers of therapeutic radioisotopes such as 177Lu for treatment of HCC.
Collapse
Affiliation(s)
- Usha Pandey
- 1 Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India.,2 Homi Bhabha National Institute, Mumbai, India
| | - Suresh Subramanian
- 1 Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India.,2 Homi Bhabha National Institute, Mumbai, India
| | - Samina Shaikh
- 2 Homi Bhabha National Institute, Mumbai, India.,3 Analytical Chemistry Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Naresh Gamre
- 1 Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Sanjukta Kumar
- 2 Homi Bhabha National Institute, Mumbai, India.,3 Analytical Chemistry Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Ashutosh Dash
- 1 Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India.,2 Homi Bhabha National Institute, Mumbai, India
| |
Collapse
|
10
|
Cappelli A, Sangro P, Mosconi C, Deppe I, Terzi E, Bilbao JI, Rodriguez-Fraile M, De Benedittis C, Ricke J, Golfieri R, Sangro B. Transarterial radioembolization in patients with hepatocellular carcinoma of intermediate B2 substage. Eur J Nucl Med Mol Imaging 2018; 46:661-668. [PMID: 30209522 DOI: 10.1007/s00259-018-4152-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 08/28/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Patients with hepatocellular carcinoma (HCC) of intermediate stage (BCLC-B according to the Barcelona Clinic Liver Cancer classification) are a heterogeneous group with different degrees of liver function impairment and tumour burden. The recommended treatment is transarterial chemoembolization (TACE). However, patients in this group may be judged as poor candidates for TACE because the risk-benefit ratio is low. Such patients may receive transarterial radioembolization (TARE) only by entering a clinical trial. Experts have proposed that the stage could be further divided into four substages based on available evidence of treatment benefit. We report here, for the first time, the outcome in patients with BCLC-B2 substage HCC treated with TARE. METHODS A retrospective analysis of the survival of 126 patients with BCLC-B2 substage HCC treated with TARE in three European hospitals was performed. RESULTS Overall median survival in patients with BCLC-B2 substage was not significantly different in relation to tumour characteristics; 19.35 months (95% CI 8.27-30.42 months) in patients with a single large (>7 cm) HCC, and 18.43 months (95% CI 15.08-21.77 months) in patients with multinodular HCC (p = 0.27). However, there was a higher proportion of long-term survivors at 36 months among those with a single large tumour (29%) than among those with multiple tumours (16.8%). CONCLUSION Given the poor efficacy of TACE in treating patients with BCLC-B2 substage HCC, TARE treatment could be a better choice, especially in those with a large tumour.
Collapse
Affiliation(s)
- Alberta Cappelli
- Radiology Unit, Department of Diagnostic and Preventive Medicine, University of Bologna, Policlinico di S.Orsola, Via Albertoni 15, 40138, Bologna, Italy
| | - Paloma Sangro
- Liver Unit, Clinica Universidad de Navarra-IDISNA and CIBEREHD, Avda. Pio XII 36, 31008, Pamplona, Spain
| | - Cristina Mosconi
- Radiology Unit, Department of Diagnostic and Preventive Medicine, University of Bologna, Policlinico di S.Orsola, Via Albertoni 15, 40138, Bologna, Italy
| | - Iris Deppe
- Liver Unit, Clinica Universidad de Navarra-IDISNA and CIBEREHD, Avda. Pio XII 36, 31008, Pamplona, Spain
| | - Eleonora Terzi
- Division of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Policlinico di S.Orsola, Bologna, Italy
| | - Jose I Bilbao
- Interventional Radiology, Clinica Universidad de Navarra-IDISNA, Pamplona, Spain
| | | | - Caterina De Benedittis
- Radiology Unit, Department of Diagnostic and Preventive Medicine, University of Bologna, Policlinico di S.Orsola, Via Albertoni 15, 40138, Bologna, Italy
| | - Jens Ricke
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Rita Golfieri
- Radiology Unit, Department of Diagnostic and Preventive Medicine, University of Bologna, Policlinico di S.Orsola, Via Albertoni 15, 40138, Bologna, Italy.
| | - Bruno Sangro
- Liver Unit, Clinica Universidad de Navarra-IDISNA and CIBEREHD, Avda. Pio XII 36, 31008, Pamplona, Spain.
| |
Collapse
|
11
|
van Nierop BJ, Prince JF, van Rooij R, van den Bosch MA, Lam MG, de Jong HW. Accuracy of SPECT/CT-based lung dose calculation for Holmium-166 hepatic radioembolization before OSEM convergence. Med Phys 2018; 45:3871-3879. [PMID: 29858506 PMCID: PMC6099428 DOI: 10.1002/mp.13024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 04/26/2018] [Accepted: 05/14/2018] [Indexed: 11/06/2022] Open
Abstract
PURPOSE In intra-arterial hepatic radioembolization using Holmium-166 (166 Ho) microspheres, a predicted lung-absorbed dose of more than 30 Gy is a contraindication for therapy. Therefore, scout imaging by means of quantitative SPECT of the lungs after a low-dose pretreatment session is essential. Earlier we showed the superiority of Monte Carlo-based iterative SPECT reconstructions over conventional reconstructions due to its quantitative nature, required for dosimetry, at the cost of substantial computation times. In clinical routine, however, the limited available time between scout imaging and therapy constrains its application. To reduce computation times, we investigated the minimum number of iterations required to guarantee a clinical acceptable accuracy in lung dose estimation using patient and phantom data. METHODS 166 Ho scout SPECT data (range: 222-283 MBq) were used from 10 patients. SPECT images were Monte Carlo-based OSEM reconstructed (effective iterations: 240). Additionally, the 4D XCAT anthropomorphic phantom was used to mimic studies with an injected scout activity of 250 MBq and with varying lung-absorbed doses ranging from 0.9 to 225 Gy for a therapeutic dosage of 15 GBq. These studies were reconstructed in the same way as the patient data, and were also reconstructed using a clinically available, standard OSEM algorithm for comparison. Lung-absorbed dose was determined using VOI analysis as a function of iterations. RESULTS The estimated lung-absorbed dose in nine patients ranged upon MC-based OSEM convergence from 0 to 0.26 Gy for a therapeutic dosage. One patient had an estimated lung absorbed-dose for a therapeutic dosage of 20.3 Gy upon MC-based OSEM convergence, or 18.4 Gy after 40 iterations (-9%). The phantom data showed that the lung-absorbed dose upon OSEM convergence was underestimated by 15% as compared to the actual simulated lung dose, and the dose after 40 iterations was underestimated by 9% as compared to the dose upon convergence. Both underestimations were irrespective of the magnitude of the lung-absorbed dose (0.9 to 225 Gy) and thus can be easily corrected for. The quantitative accuracy of the MC-based OSEM reconstructions (40 iterations, before convergence) outperformed the clinical OSEM reconstruction while estimating the lung dose. CONCLUSIONS The number of effective iterations necessary for quantitative estimation of the lung dose using MC-based OSEM can be reduced from 240 to 40. The resulting sixfold reduction in calculation time enables processing of the scout images before therapy administration.
Collapse
Affiliation(s)
- Bastiaan J. van Nierop
- Department of Radiology and Nuclear MedicineUniversity Medical Centre UtrechtP.O. Box 85500UtrechtGA3508The Netherlands
| | - Jip F. Prince
- Department of Radiology and Nuclear MedicineUniversity Medical Centre UtrechtP.O. Box 85500UtrechtGA3508The Netherlands
| | - Rob van Rooij
- Department of Radiology and Nuclear MedicineUniversity Medical Centre UtrechtP.O. Box 85500UtrechtGA3508The Netherlands
| | - Maurice A.A.J. van den Bosch
- Department of Radiology and Nuclear MedicineUniversity Medical Centre UtrechtP.O. Box 85500UtrechtGA3508The Netherlands
| | - Marnix G.E.H. Lam
- Department of Radiology and Nuclear MedicineUniversity Medical Centre UtrechtP.O. Box 85500UtrechtGA3508The Netherlands
| | - Hugo W.A.M. de Jong
- Department of Radiology and Nuclear MedicineUniversity Medical Centre UtrechtP.O. Box 85500UtrechtGA3508The Netherlands
| |
Collapse
|
12
|
Nazzal M, Gadani S, Said A, Rice M, Okoye O, Taha A, Lentine KL. Liver targeted therapies for hepatocellular carcinoma prior to transplant: contemporary management strategies. GLOBAL SURGERY (LONDON) 2018; 4. [PMID: 29782618 DOI: 10.15761/gos.1000171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hepatocellular carcinoma (HCC) is an aggressive neoplastic disease that has been rapidly increasing in incidence. It usually occurs in the background of liver disease, and cirrhosis. Definitive therapy requires surgical resection. However, in majority of cases surgical resection is not tolerated, especially in the presence of portal hypertension and cirrhosis. Orthotopic liver transplant (OLT) in well selected candidates has been accepted as a viable option. Due to a relative scarcity of donors compared to the number of listed recipients, long waiting times are anticipated. To prevent patients with HCC from dropping out from the transplant list due to progression of their disease, most centers utilize loco-regional therapies. These loco-regional therapies(LRT) include minimally invasive treatments like percutaneous thermal ablation, trans-arterial chemoembolization, trans-arterial radio-embolization or a combination thereof. The type of therapy or combination used is determined by the size and location of the HCC and Barcelona Clinic Liver Cancer (BCLC) classification. The data regarding the efficacy of LRT in reducing post-transplant recurrence or disease-free survival is limited. This article reviews the available therapies, their strengths, limitations, and current use in the management of patients with hepatocellular carcinoma awaiting transplant.
Collapse
Affiliation(s)
- Mustafa Nazzal
- Division of Abdominal Transplant Surgery, Department of General Surgery, St. Louis University Hospital, USA
| | - Sameer Gadani
- Interventional Radiology, Department of Radiology, St. Louis University Hospital, USA
| | - Abdullah Said
- Division of Abdominal Transplant Surgery, Department of General Surgery, St. Louis University Hospital, USA
| | - Mandy Rice
- Division of Abdominal Transplant Surgery, Department of General Surgery, St. Louis University Hospital, USA
| | - Obi Okoye
- Division of Abdominal Transplant Surgery, Department of General Surgery, St. Louis University Hospital, USA
| | - Ahmad Taha
- Division of Abdominal Transplant Surgery, Department of General Surgery, St. Louis University Hospital, USA
| | - Krista L Lentine
- Division of Abdominal Transplant Surgery, Department of General Surgery, St. Louis University Hospital, USA.,Division of Nephrology, Department of Medicine, St Louis University Hospital, USA
| |
Collapse
|
13
|
Venditti I, Cartoni A, Fontana L, Testa G, Scaramuzzo F, Faccini R, Terracciano CM, Camillocci ES, Morganti S, Giordano A, Scotognella T, Rotili D, Dini V, Marini F, Fratoddi I. Y3+ embedded in polymeric nanoparticles: Morphology, dimension and stability of composite colloidal system. Colloids Surf A Physicochem Eng Asp 2017. [DOI: 10.1016/j.colsurfa.2017.05.082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
14
|
Daecher A, Stanczak M, Liu JB, Zhang J, Du S, Forsberg F, Leeper DB, Eisenbrey JR. Localized microbubble cavitation-based antivascular therapy for improving HCC treatment response to radiotherapy. Cancer Lett 2017; 411:100-105. [PMID: 28969964 DOI: 10.1016/j.canlet.2017.09.037] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/21/2017] [Accepted: 09/21/2017] [Indexed: 01/15/2023]
Abstract
Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide and the fastest growing malignancy in the United States. With a 5-year survival rate below 12%, effective therapies for HCC are needed. Current treatments for HCC include microwave and radiofrequency ablation, high intensity focused ultrasound, liver transplant, surgical resection, and localized embolizations. However, each of these approaches has some limitation, making it imperative to develop improved methods for sensitizing tumors prior to therapy. We hypothesized that the use of ultrasound-triggered microbubble destruction (UTMD), which sensitizes tumors to radiotherapy by inducing vascular endothelial cell apoptosis, will selectively sensitize malignant tissue to radiotherapy and improve outcomes. To test this, 18 nude rats were inoculated in the right liver lobe with Hu7.5 HCC cells and after tumor formation, received 5 Gy radiotherapy, UTMD, or UTMD prior to radiotherapy. Compared to radiotherapy alone, there was a 170% reduction in tumor growth 7 days post treatment and a 3.2X improvement in median survival time when radiotherapy was combined with UTMD. These results indicate that UTMD is an effective adjunct when combined with radiotherapy to treat HCC.
Collapse
Affiliation(s)
- Annemarie Daecher
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Maria Stanczak
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Ji-Bin Liu
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Jie Zhang
- Tianjin Medical University General Hospital, Heping District, Tianjin 300052, China
| | - Shisuo Du
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Flemming Forsberg
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Dennis B Leeper
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - John R Eisenbrey
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
| |
Collapse
|
15
|
Towards a patient-specific hepatic arterial modeling for microspheres distribution optimization in SIRT protocol. Med Biol Eng Comput 2017; 56:515-529. [DOI: 10.1007/s11517-017-1703-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 08/03/2017] [Indexed: 12/17/2022]
|
16
|
T Cell-Activating Mesenchymal Stem Cells as a Biotherapeutic for HCC. MOLECULAR THERAPY-ONCOLYTICS 2017; 6:69-79. [PMID: 28856237 PMCID: PMC5562179 DOI: 10.1016/j.omto.2017.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 07/25/2017] [Indexed: 01/10/2023]
Abstract
The outcome for advanced stage hepatocellular carcinoma (HCC) remains poor, highlighting the need for novel therapies. Genetically modified mesenchymal stem cells (MSCs) are actively being explored as cancer therapeutics due to their inherent ability to migrate to tumor sites. We reasoned that MSCs can be genetically modified to redirect T cells to Glypican-3 (GPC3)+ HCC, and genetically modified these with viral vectors encoding a GPC3/CD3 bispecific T cell engager (GPC3-ENG), a bispecifc T cell engager specific for an irrelevant antigen (EGFRvIII), and/or costimulatory molecules (CD80 and 41BBL). Coculture of GPC3+ cells, GPC3-ENG MSCs, and T cells resulted in T cell activation, as judged by interferon γ (IFNγ) production and killing of tumor cells by T cells. Modification of GPC3-ENG MSCs with CD80 and 41BBL was required for antigen-dependent interleukin-2 (IL-2) production by T cells and resulted in faster tumor cell killing by redirected T cells. In vivo, GPC3-ENG MSCs ± costimulatory molecules had antitumor activity in the HUH7 HCC xenograft model, resulting in a survival advantage. In conclusion, MSCs genetically modified to express GPC3-ENG ± costimulatory molecules redirect T cells to GPC3+ tumor cells and have potent antitumor activity. Thus, further preclinical exploration of our modified approach to GPC3-targeted immunotherapy for HCC is warranted.
Collapse
|
17
|
Simoncini C, Rolland Y, Morgenthaler V, Jurczuk K, Saint-Jalmes H, Eliat PA, Kretowski M, Bezy-Wendling J. Blood Flow Simulation in Patient-Specific Segmented Hepatic Arterial Tree. Ing Rech Biomed 2017. [DOI: 10.1016/j.irbm.2017.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
18
|
Cheng JS, Chou CT, Liu YY, Sun WC, Shieh P, Kuo DH, Kuo CC, Jan CR, Liang WZ. The effect of oleuropein from olive leaf (Olea europaea) extract on Ca²⁺ homeostasis, cytotoxicity, cell cycle distribution and ROS signaling in HepG2 human hepatoma cells. Food Chem Toxicol 2016; 91:151-66. [PMID: 27016494 DOI: 10.1016/j.fct.2016.03.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 02/23/2016] [Accepted: 03/21/2016] [Indexed: 12/28/2022]
Abstract
Oleuropein, a phenolic compound found in the olive leaf (Olea europaea), has been shown to have biological activities in different models. However, the effects of oleuropein on Ca(2+) homeostasis, cytotoxicity, cell cycle distribution and ROS signaling in liver cells have not been analyzed. Oleuropein induced [Ca(2+)]i rises only in HepG2 cells but not in AML12, HA22T or HA59T cells due to the different status of 3-hydroxy-3-methylglutaryl-CoA reductase expression. In HepG2 cells, this Ca(2+) signaling response was reduced by removing extracellular Ca(2+), and was inhibited by the store-operated Ca(2+) channel blockers 2-APB and SKF96365. In Ca(2+)-free medium, pretreatment with the ER Ca(2+) pump inhibitor thapsigargin abolished oleuropein-induced [Ca(2+)]i rises. Oleuropein induced cell cycle arrest which was associated with the regulation of p53, p21, CDK1 and cyclin B1 levels. Furthermore, oleuropein elevated intracellular ROS levels but reduced GSH levels. Treatment with the intracellular Ca(2+) chelator BAPTA-AM or the antioxidant NAC partially reversed oleuropein-induced cytotoxicity. Together, in HepG2 cells, oleuropein induced [Ca(2+)]i rises by releasing Ca(2+) from the ER and causing Ca(2+) influx through store-operated Ca(2+) channels. Moreover, oleuropein induced Ca(2+)-associated cytotoxicity that involved ROS signaling and cell cycle arrest. This compound may offer a potential therapy for treatment of human hepatoma.
Collapse
Affiliation(s)
- Jin-Shiung Cheng
- Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Chiang-Ting Chou
- Department of Nursing, Division of Basic Medical Sciences, Chang Gung University of Science and Technology, Chia-Yi 613, Taiwan; Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chia-Yi 613, Taiwan
| | - Yuan-Yuarn Liu
- Division of Trauma, Department of Emergency, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Wei-Chih Sun
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Pochuen Shieh
- Department of Pharmacy, Tajen University, Pingtung 907, Taiwan
| | - Daih-Huang Kuo
- Department of Pharmacy, Tajen University, Pingtung 907, Taiwan
| | - Chun-Chi Kuo
- Department of Nursing, Tzu Hui Institute of Technology, Pingtung 907, Taiwan
| | - Chung-Ren Jan
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Wei-Zhe Liang
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
| |
Collapse
|
19
|
Mauer K, O'Kelley R, Podda N, Flanagan S, Gadani S. New treatment modalities for hepatocellular cancer. Curr Gastroenterol Rep 2015; 17:442. [PMID: 25869473 DOI: 10.1007/s11894-015-0442-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Heptatocellular (HCC) is a rapidly progressive fatal malignancy often presenting at an advanced stage at the time of initial diagnosis. Loco-regional therapies for early-stage HCC including surgical options (surgical resection and liver transplant) and percutaneous ablations could be potentially curative. Recent technological advances in percutaneous image-guided ablations have provided clinicians with a range of options which have proven to be equal to or better than surgical resection. For intermediate- and advanced-stage HCC, palliative therapies are available which significantly increase overall and progression-free survival. These palliative therapies include intra-arterial chemo- or radioembolization as monotherapy or in combination with percutaneous ablation or antiangiogenic drugs. Availability of a multitude of treatment options for various stages of HCC as well as conflicting data comparing their safety and efficacy presented in the several randomized controlled trials poses a significant challenge to hepatologists, surgeons, and interventional radiologists in selecting optimal therapy for their patients. The aim of this article is to review and discuss currently available therapies at each stage of HCC along with presenting clinical data published in most recent and relevant randomized controlled trials.
Collapse
Affiliation(s)
- Kurt Mauer
- Division of Interventional Radiology, Department of Radiology, Saint Louis University School of Medicine, 3635 Vista Ave at Grand Blvd, St Louis, MO, 63110, USA,
| | | | | | | | | |
Collapse
|
20
|
Stereotactic Body Radiation Therapy for Liver Cancer: A Review of the Technology. J Med Imaging Radiat Sci 2015; 46:343-350. [PMID: 31052142 DOI: 10.1016/j.jmir.2015.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 05/25/2015] [Accepted: 06/17/2015] [Indexed: 12/25/2022]
Abstract
Stereotactic body radiation therapy has been adopted in the treatment of liver cancer because of its highly conformal dose distribution when compared with other conventional approaches, and many studies have been published to report the positive clinical outcome associated with this technique. To achieve the precision needed to maintain or to improve the therapeutic ratio, various strategies are applied in different components in the stereotactic body radiation therapy process. Immobilization devices are used in minimizing geometric uncertainty induced by treatment positioning and internal organ motion. Along with a better definition of target by the integration of multimodality imaging, planning target volume margin to compensate for the uncertainty can be reduced to minimize inclusion of normal tissue in the treatment volume. In addition, sparing of normal tissue from irradiation is improved by the use of high precision treatment delivery technologies such as intensity-modulated radiotherapy or volumetric modulated arc therapy. Target localization before treatment delivery with image guidance enables reproduction of the patient's geometry for delivering the planned dose. The application of these advanced technologies contributes to the evolution of the role of radiation therapy in the treatment of liver cancer, making it an important radical or palliative treatment modality.
Collapse
|
21
|
Kanda T, Ogasawara S, Chiba T, Haga Y, Omata M, Yokosuka O. Current management of patients with hepatocellular carcinoma. World J Hepatol 2015; 7:1913-1920. [PMID: 26244066 PMCID: PMC4517151 DOI: 10.4254/wjh.v7.i15.1913] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/02/2015] [Accepted: 06/08/2015] [Indexed: 02/06/2023] Open
Abstract
The current management therapies for hepatocellular carcinoma (HCC) patients are discussed in this review. Despite the development of new therapies, HCC remains a “difficult to treat” cancer because HCC typically occurs in advanced liver disease or hepatic cirrhosis. The progression of multistep and multicentric HCC hampers the prevention of the recurrence of HCC. Many HCC patients are treated with surgical resection and radiofrequency ablation (RFA), although these modalities should be considered in only selected cases with a certain HCC number and size. Although there is a shortage of grafts, liver transplantation has the highest survival rates for HCC. Several modalities are salvage treatments; however, intensive care in combination with other modalities or in combination with surgical resection or RFA might offer a better prognosis. Sorafenib is useful for patients with advanced HCC. In the near future, HCC treatment will include stronger molecular targeted drugs, which will have greater potency and fewer adverse events. Further studies will be ongoing.
Collapse
|
22
|
Waghray A, Murali AR, Menon KVN. Hepatocellular carcinoma: From diagnosis to treatment. World J Hepatol 2015; 7:1020-1029. [PMID: 26052391 PMCID: PMC4450179 DOI: 10.4254/wjh.v7.i8.1020] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 01/15/2015] [Accepted: 02/12/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the sixth most prevalent malignancy worldwide and is a rising cause of cancer related mortality. Risk factors for HCC are well documented and effective surveillance and early diagnosis allow for curative therapies. The majority of HCC appears to be caused by cirrhosis from chronic hepatitis B and hepatitis C virus. Preventive strategies include vaccination programs and anti-viral treatments. Surveillance with ultrasonography detects early stage disease and improves survival rates. Many treatment options exist for individuals with HCC and are determined by stage of presentation. Liver transplantation is offered to patients who are within the Milan criteria and are not candidates for hepatic resection. In patients with advanced stage disease, sorafenib shows some survival benefit.
Collapse
|
23
|
Gao H, Wang H, Peng J. Hispidulin induces apoptosis through mitochondrial dysfunction and inhibition of P13k/Akt signalling pathway in HepG2 cancer cells. Cell Biochem Biophys 2014; 69:27-34. [PMID: 24068521 DOI: 10.1007/s12013-013-9762-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Hispidulin is a flavonoid compound which is an active ingredient in a number of traditional Chinese medicinal herbs. However, it's therapeutic activity remains poorly understood. The present study investigated the pro-apoptotic effects and mechanism by which Hispidulin induces apoptosis in human hepatoblastoma cancer (HepG2) cells. The results showed that Hispidulin induced cell death in a dose- and time-dependent manner in HepG2 cells whereas no toxic reaction was observed in normal human liver cells at indicated concentration. This study also demonstrated that Hispidulin induces apoptosis through mitochondrial dysfunction, which is characterized by decreased Bcl-2/Bax ratio, disrupted mitochondrial membrane potential and increased release of cytochrome C and activated capase-3. Our results also showed that mitochondrial dysfunction was triggered by Hispidulin-induced excessive ROS generation. Hispidulin also significantly inhibited Akt activation. ROS inhibitor NAC abrogated the inhibitory effect of Hispidulin on P13k/Akt signalling pathway and the proapoptotic effect in HepG2 cells. Our results demonstrate for the first time that Hispidulin induces apoptosis in HepG2 cells and suggested that the pro-apoptotic effect of Hispidulin was mediated through mitochondrial dysfunction and inhibition of P13k/Akt signalling pathway. Since no toxic effect was observed when normal liver cells were treated with Hispidulin, Hispidulin may have the potential to be used as therapeutic for liver cancer.
Collapse
Affiliation(s)
- Hui Gao
- Medical College, Qingdao University, Qingdao, 266021, Shandong, China,
| | | | | |
Collapse
|
24
|
Interval between intra-arterial infusion chemotherapy and surgery for locally advanced oral squamous cell carcinoma: impacts on effectiveness of chemotherapy and on overall survival. ScientificWorldJournal 2014; 2014:568145. [PMID: 24963509 PMCID: PMC4052512 DOI: 10.1155/2014/568145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/30/2014] [Indexed: 11/23/2022] Open
Abstract
Background. The interval between intra-arterial infusion chemotherapy (IAIC) and surgery was investigated in terms of its effects on survival in patients with locally advanced oral squamous cell carcinoma (OSCC).
Methods. This retrospective study analyzed 126 patients who had completed treatment modalities for stage IV OSCC. All patients were followed up for 3 years. Kaplan-Meier and Cox regression methods were used to determine how survival was affected by general factors, primary tumor volume, TNM stage, and duration of neoadjuvant chemotherapy. Results. In 126 patients treated for locally advanced OSCC by preoperative induction IAIC using methotrexate, multivariate analysis of relevant prognostic factors showed that an IAIC duration longer than 90 days was significantly associated with poor prognosis (hazard ratio, 1.77; P = 0.0259).
Conclusions. Duration of IAIC is a critical factor in the effectiveness of multimodal treatment for locally advanced OSCC. Limiting the induction course to 90 days improves overall survival.
Collapse
|
25
|
Alantolactone induces apoptosis in HepG2 cells through GSH depletion, inhibition of STAT3 activation, and mitochondrial dysfunction. BIOMED RESEARCH INTERNATIONAL 2012; 2013:719858. [PMID: 23533997 PMCID: PMC3591150 DOI: 10.1155/2013/719858] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 10/24/2012] [Accepted: 10/24/2012] [Indexed: 02/06/2023]
Abstract
Signal transducer and activator of transcription 3 (STAT3) constitutively expresses in human liver cancer cells and has been implicated in apoptosis resistance and tumorigenesis. Alantolactone, a sesquiterpene lactone, has been shown to possess anticancer activities in various cancer cell lines. In our previous report, we showed that alantolactone induced apoptosis in U87 glioblastoma cells via GSH depletion and ROS generation. However, the molecular mechanism of GSH depletion remained unexplored. The present study was conducted to envisage the molecular mechanism of alantolactone-induced apoptosis in HepG2 cells by focusing on the molecular mechanism of GSH depletion and its effect on STAT3 activation. We found that alantolactone induced apoptosis in HepG2 cells in a dose-dependent manner. This alantolactone-induced apoptosis was found to be associated with GSH depletion, inhibition of STAT3 activation, ROS generation, mitochondrial transmembrane potential dissipation, and increased Bax/Bcl-2 ratio and caspase-3 activation. This alantolactone-induced apoptosis and GSH depletion were effectively inhibited or abrogated by a thiol antioxidant, N-acetyl-L-cysteine (NAC). The data demonstrate clearly that intracellular GSH plays a central role in alantolactone-induced apoptosis in HepG2 cells. Thus, alantolactone may become a lead chemotherapeutic candidate for the treatment of liver cancer.
Collapse
|
26
|
Hosseini SH, Enferadi M, Sadeghi M. Dosimetric aspects of 166Ho brachytherapy biodegradable glass seed. Appl Radiat Isot 2012; 73:109-15. [PMID: 23313765 DOI: 10.1016/j.apradiso.2012.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 10/27/2012] [Accepted: 12/04/2012] [Indexed: 11/20/2022]
Abstract
The purpose of this study is to perform absorbed dose calculations based on Monte Carlo simulations for a novel beta emitter bioglass Ho-166 seed which is proposed for treating small hepatocellular carcinomas (HCCs). The bioactive glass seed has been developed by use of the sol-gel method. Monte Carlo simulations were carried out for the seed using the version 5 of the (MCNP) Monte Carlo radiation transport code to investigate the dosimetric parameters recommended by the AAPM Task Group 60 (TG-60). Dose distributions due to the beta and photon radiation were obtained at different radial distances surrounding the source. The dose rate in water at the reference point was calculated to be 6.71 ± 0.4 cGy h(-1) μCi(-1). The anisotropy function values ranging from 0.745 to 1.928 were obtained for radial distances of 0.3-8 mm and polar angles of 0°-90°. The (166)Ho seed source can deliver high radiation doses to the tumor, while the short range of the beta particles limits damage to the adjacent normal tissue.
Collapse
Affiliation(s)
- S Hamed Hosseini
- Department of Biomedical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | | | | |
Collapse
|