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Zhao F, Wang X, Zhu W, Zhao D, Ye C, Guo Y, Dou Y. Low-dose pleiotropic radiosensitive nanoformulations for three-pronged radiochemotherapy of hypoxic brain glioblastoma under BOLD/DWI monitoring. Cancer Nanotechnol 2023. [DOI: 10.1186/s12645-023-00159-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
Hypoxia-mediated radioresistance is the main obstacle to the successful treatment of glioblastoma (GBM). Enhancing hypoxic radiosensitivity and alleviating tumor hypoxia are both effective means to improve therapeutic efficacy, and the combination of the two is highly desirable and meaningful.
Results
Herein, we construct a low-dose pleiotropic radiosensitive nanoformulation consisting of a high-Z atomic nanocrystal core and mesoporous silica shell, surface-modified with angiopep-2 (ANG) peptide and loaded with nitric oxide (NO) donor and hypoxia-activated prodrug (AQ4N). Benefiting from ANG-mediated transcytosis, this nanoformulation can efficiently cross the BBB and accumulate preferentially in the brain. Low-dose radiation triggers this nanoformulation to exert a three-pronged synergistic therapeutic effect through high-Z-atom-dependent dose deposition enhancement, NO-mediated hypoxia relief, and AQ4N-induced hypoxia-selective killing, thereby significantly inhibiting GBM in situ growth while prolonging survival and maintaining stable body weight in the glioma-bearing mice. Meanwhile, the proposed in vivo 9.4 T BOLD/DWI can realize real-time dynamic assessment of local oxygen supply and radiosensitivity to monitor the therapeutic response of GBM.
Conclusions
This work provides a promising alternative for hypoxia-specific GBM-targeted comprehensive therapy, noninvasive monitoring, and precise prognosis.
Graphical Abstract
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Using quantitative MRI to study the association of isocitrate dehydrogenase (IDH) status with oxygen metabolism and cellular structure changes in glioma. Eur J Radiol 2022; 155:110502. [PMID: 36049408 DOI: 10.1016/j.ejrad.2022.110502] [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: 06/14/2022] [Revised: 08/14/2022] [Accepted: 08/23/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the characteristics of oxygen metabolism and the cellular structure of glioma using quantitative MRI to predict the isocitrate dehydrogenase 1 (IDH1) status and to further understand the biological characteristics of gliomas. METHODS In this retrospective study, 94 patients with gliomas eventually received quantitative MRI measures to study oxygen metabolism. The oxygen metabolism biomarker maps (oxygen extraction fraction [OEF] and cerebral metabolic rate of oxygen [CMRO2]) and the tissue-cellular-specific (R2t*) MRI relaxation parameter were evaluated in different regions of glioma. RESULTS MRI results showed differences in oxygen metabolism measures in all patients with gliomas of different IDH1 statuses. Compared to patients with IDH1 mutant gliomas, patients with IDH1 wild type gliomas showed increased (P < 0.01) CMRO2, OEF, cerebral blood volume [CBF], and R2t* measures in tumor regions, while only OEF, CBF and R2t* were found to be increased (P < 0.05) in the peritumoral area. OEF achieved the best performance for distinguishing IDH1 wild type and mutant gliomas in the tumor area (AUC = 0.732, P < 0.001). R2t* values correlated with Ki-67(R = 0.35, P < 0.001) in the tumor area, while no significant correlations between Ki-67 and R2t* were found in the peritumoral area (R = 0.19, P = 0.072). CONCLUSION Quantitative MRI has potential applications in studying the tumor and peritumoral areas of glioma, and it has the ability to predict and reveal the characteristics of oxygen metabolism and cellular structure in different regions of gliomas.
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Stadlbauer A, Oberndorfer S, Zimmermann M, Renner B, Buchfelder M, Heinz G, Doerfler A, Kleindienst A, Roessler K. Physiologic MR imaging of the tumor microenvironment revealed switching of metabolic phenotype upon recurrence of glioblastoma in humans. J Cereb Blood Flow Metab 2020; 40:528-538. [PMID: 30732550 PMCID: PMC7026844 DOI: 10.1177/0271678x19827885] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Treating recurrent glioblastoma (GB) is one of the challenges in modern neurooncology. Hypoxia, neovascularization, and energy metabolism are of crucial importance for therapy failure and recurrence. Twenty-one patients with initially untreated GB who developed recurrence were examined with a novel MRI approach for noninvasive visualization of the tumor microenvironment (TME). Imaging biomarker information about oxygen metabolism (mitochondrial oxygen tension) and neovascularization (microvascular density and type) were fused for classification of five different TME compartments: necrosis, hypoxia with/without neovascularization, oxidative phosphorylation, and glycolysis. Volume percentages of these TME compartments were compared between untreated and recurrent GB. At initial diagnosis, all 21 GB showed either the features of a glycolytic dominant phenotype with a high percentage of functional neovasculature (N = 12) or those of a necrotic/hypoxic dominant phenotype with a high percentage of defective tumor neovasculature (N = 9). At recurrence, all 21 GB revealed switching of the initial metabolic phenotype: either from the glycolytic to the necrotic/hypoxic dominant phenotype or vice-versa. A necrotic/hypoxic phenotype at recurrence was associated with a higher rate of multifocality of the recurrent lesions. Our MRI approach may be helpful for a better understanding of treatment-induced metabolic phenotype switching and for future studies developing targeted therapeutic strategies for recurrent GB.
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Affiliation(s)
- Andreas Stadlbauer
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany.,Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Stefan Oberndorfer
- Department of Neurology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Max Zimmermann
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Bertold Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Gertraud Heinz
- Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Arnd Doerfler
- Department of Neuroradiology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Andrea Kleindienst
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Karl Roessler
- Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
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Brouwer RJ, Engberts AC, Borger van der Burg BL, van Dongen TT, van Hulst RA, Hoencamp R. Meta-analysis on the effect of hyperbaric oxygen as adjunctive therapy in the outcome of anastomotic healing of experimental colorectal resections in rats. Diving Hyperb Med 2019; 48:173-185. [PMID: 30199890 DOI: 10.28920/dhm48.3.173-185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Colorectal cancer is the third most common form of cancer and colorectal surgery is the treatment of choice in local disease. Anastomotic leakage following colorectal surgery is a major complication with a high incidence and mortality. Adjuvant hyperbaric oxygen treatment (HBOT) may be associated with reduction of anastomotic leakage. A systematic review was conducted regarding HBOT as an adjunctive therapy to colorectal surgery. METHODS Systematic review (1900-2017) using PubMed, Cochrane, EMBASE, Web of Science and EMCARE. All original published studies on the effect of HBOT as an adjunctive therapy for colorectal surgery with the creation of an anastomosis were considered. RESULTS Thirteen small animal trials were included for qualitative synthesis. We found no human trials. Eleven trials used bursting pressure whilst eight used hydroxyproline levels as a marker for collagen synthesis as primary outcome to assess the strength of the anastomosis. A meta-analysis performed for normal and ischaemic anastomoses showed that postoperative HBOT improves bursting pressure and hydroxyproline levels significantly in both normal (p ≤ 0.001 and p = 0.02) and ischaemic anastomoses (p ≤ 0.001 and p = 0.04). CONCLUSION Postoperative HBOT has a positive effect on colorectal anastomoses in rats. Further research should focus on a larger systematic animal study.
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Affiliation(s)
- Robin J Brouwer
- Corresponding author: Department of Surgery, Alrijne Hospital, Simon Smitweg 1, 2353 GA Leiderdorp, The Netherlands,
| | | | | | - Thijs Tcf van Dongen
- Department of Surgery, Alrijne Hospital, Leiderdorp, The Netherlands.,Defense Healthcare Organization, Ministry of Defense, Utrecht, The Netherlands
| | - Rob A van Hulst
- Department of Anesthesiology, Amsterdam Medical Center, Amsterdam, The Netherlands.,Maritime Medical Expertise Center, Diving Medical Center, Royal Netherlands Navy, Den Helder, The Netherlands
| | - Rigo Hoencamp
- Department of Surgery, Alrijne Hospital, Leiderdorp, The Netherlands.,Defense Healthcare Organization, Ministry of Defense, Utrecht, The Netherlands.,Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
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5
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Wolf B, Scholze C. [Medicine 4.0: examples of applications of electronics, information technology and microsystems in modern medicine]. Med Sci (Paris) 2018; 34:978-983. [PMID: 30526835 DOI: 10.1051/medsci/2018236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The electronic advances of the last hundred years have made enormous contributions to medical research and the development of new therapeutic methods. In recent years in particular, it has been demonstrated that intelligent sensors, with appropriate radio interfaces, will soon allow diagnostic and therapeutic processes in medicine to be linked to one another - this will enable the development of completely new forms of therapy [1]. This new "Medicine 4.0" was the subject of a first article in the series, which presented the progress achieved through the merging of microsensor technology, microelectronics, information and communication technologies, with a particular focus on the case of personalized chemotherapy. The purpose of this new article is to present more practical applications of these new therapeutic methods.
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Affiliation(s)
- Bernhard Wolf
- Chaire Heinz Nixdorf en électronique médicale, université technique de Munich, Theresienstrasse 90/N3, 80333 Munich, Allemagne - Steinbeis-Transferzentrum Medizinische Elektronik, Lab on Chip Systeme, Fendstrasse 7, 80802 Munich, Allemagne
| | - Christian Scholze
- Chaire Heinz Nixdorf en électronique médicale, université technique de Munich, Theresienstrasse 90/N3, 80333 Munich, Allemagne - Steinbeis-Transferzentrum Medizinische Elektronik, Lab on Chip Systeme, Fendstrasse 7, 80802 Munich, Allemagne
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6
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Fan Q, Tang CY, Gu D, Zhu J, Li G, Wu Y, Tao X. Investigation of hypoxia conditions using oxygen-enhanced magnetic resonance imaging measurements in glioma models. Oncotarget 2018; 8:31864-31875. [PMID: 28418866 PMCID: PMC5458254 DOI: 10.18632/oncotarget.16256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 02/20/2017] [Indexed: 11/25/2022] Open
Abstract
The objective of this study was to determine whether using oxygen-enhanced magnetic resonance imaging (OE-MRI) to assess hypoxia is feasible and whether historical measurements, pO2 changes, and percentage of signal intensity changes (PSIC) are correlated in an animal model of glioma. A total of 25 Sprague-Dawley rats were used to establish C6 brain or subcutaneous glioma model. Nine rats with brain gliomas underwent OE-MRI followed by histopathologic analysis to assess microvessel density and hypoxia. Another 11 rats were underwent OE-MRI and were followed for a survival analysis. Time-T1-weighted MR signal intensity (SI) curves and PSIC maps were derived from the OE-MRI data. High-regions of interests (ROI-h; PSIC > 10%) and low-ROIs (ROI-l; PSIC < 10%) were defined on the PSIC maps. To validate the PSIC map for identifying tumor hypoxia, we subjected an additional 5 rats with subcutaneous glioma to OE-MRI and pO2 measurements. All tumors showed regional heterogeneity on the PSIC maps. For the brain tumors, the time-SI curves for the ROIs-h showed a greater increase in SI than those for the ROIs-l did. The percentage of tumor area with a low PSIC was significantly correlated with the percentage of hypoxia staining and necrosis (r =0.71; P<0.05). ROIs with a higher PSIC typically had more vessels (r=0.88; P<0.05). A significant difference in survival was shown (log-rank P = 0.035). The time-pO2 curves of the subcutaneous tumors were similar to the time-SI curves. PSIC was significantly correlated with pO2 changes (r =0.82; P<0.05). These findings suggest that OE-MRI measurements can be used to assess hypoxia in C6 glioma models. In these models, the PSIC value was correlated with survival, indicating that PSIC could serve as a prognostic marker for glioma.
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Affiliation(s)
- Qi Fan
- Radiology Department, Shanghai People's Ninth Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Cheuk Ying Tang
- Radiology Department, Mount Sinai School of Medicine, New York, NY, USA
| | - Di Gu
- Department of Urology, Shanghai First People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Jinyu Zhu
- Radiology Department, Shanghai People's Ninth Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Guojun Li
- Departments of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yingwei Wu
- Radiology Department, Shanghai People's Ninth Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Xiaofeng Tao
- Radiology Department, Shanghai People's Ninth Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
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Sun Y, Wen Y, Shen C, Zhu Y, You W, Meng Y, Chen L, Feng Y, Yang X, Chen ZB. Hyperbaric Oxygen Therapy in Liver Diseases. Int J Med Sci 2018; 15:782-787. [PMID: 30008587 PMCID: PMC6036079 DOI: 10.7150/ijms.24755] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 04/12/2018] [Indexed: 12/16/2022] Open
Abstract
Hyperbaric oxygen therapy (HBOT) is an efficient therapeutic option to improve progress of lots of diseases especially hypoxia-related injuries, and has been clinically established as a wide-used therapy for patients with carbon monoxide poisoning, decompression sickness, arterial gas embolism, problematic wound, and so on. In the liver, most studies positively evaluated HBOT as a potential therapeutic option for liver transplantation, acute liver injury, nonalcoholic steatohepatitis, fibrosis and cancer, especially for hepatic artery thrombosis. This might mainly attribute to the anti-oxidation and anti-inflammation of HBOT. However, some controversies are existed, possibly due to hyperbaric oxygen toxicity. This review summarizes the current understandings of the role of HBOT in liver diseases and hepatic regeneration. Future understanding of HBOT in clinical trials and its in-depth mechanisms may contribute to the development of this novel adjuvant strategy for clinical therapy of liver diseases.
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Affiliation(s)
- Yun Sun
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.,Department of Hyperbaric Oxygen, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yankai Wen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.,Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chanjuan Shen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.,Department of Hyperbaric Oxygen, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yuanrun Zhu
- Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Wendong You
- Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yuanyuan Meng
- Department of Pediatric Medicine, The Children's Hospital, Zhejiang University, Hangzhou, China
| | - Lijuan Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.,Department of Hyperbaric Oxygen, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yiping Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.,Department of Hyperbaric Oxygen, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Xiaofeng Yang
- Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Zuo-Bing Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.,Department of Hyperbaric Oxygen, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
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8
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Tomifuji M, Araki K, Yamashita T, Shiotani A. Salvage Transoral Videolaryngoscopic Surgery for radiorecurrent hypopharyngeal and supraglottic cancer. Auris Nasus Larynx 2016; 44:464-471. [PMID: 27856033 DOI: 10.1016/j.anl.2016.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/16/2016] [Accepted: 10/19/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the feasibility of Transoral Videolaryngoscopic Surgery (TOVS) for radiorecurrent supraglottic and hypopharyngeal cancer, and to compare survival and complications between primary and radiorecurrent cases. METHODS Twelve cases of salvage TOVS for radiorecurrent cancer and 53 cases of TOVS as an initial treatment (primary cases) were evaluated. Days to resume soft diet, Functional Outcomes of Swallowing Scale (FOSS), postoperative complications, epithelization days and survival outcomes were assessed by retrospective chart review. RESULTS FOSS score was significantly worse in salvage cases compared with primary cases. Bleeding and airway compromise was slightly greater in salvage cases than in primary cases; however, this was not statistically significant. Wound healing was significantly delayed in salvage cases compared with primary cases (P<0.001). In primary cases, wounds were re-epithelized within 60 days in 83% of patients and within 90 days in almost all patients, while in salvage cases 42% of patients required more than 90 days for wound healing. In salvage cases, the 5-year overall survival, disease specific survival rate, local control rate, and laryngeal preservation rate was 85.7%, 85.7%, 62.5%, and 78.0%, respectively, and 85.7%, 98.0%, 91.3%, and 97.8%, respectively, for primary cases. Local control rate was significantly better in primary cases than in salvage cases. CONCLUSION Salvage TOVS was feasible in highly selected cases. After serial transoral surgery, the final laryngeal preservation rate was satisfactory. Swallowing function in salvage cases tended to be worse than in primary cases, and a significantly longer time was required for wound healing.
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Affiliation(s)
- Masayuki Tomifuji
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan.
| | - Koji Araki
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan
| | - Taku Yamashita
- Kitasato University School of Medicine, Department of Otorhinolaryngology - Head and Neck Surgery, Kanagawa, Japan
| | - Akihiro Shiotani
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan
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9
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Braks JAM, Spiegelberg L, Koljenovic S, Ridwan Y, Keereweer S, Kanaar R, Wolvius EB, Essers J. Optical Imaging of Tumor Response to Hyperbaric Oxygen Treatment and Irradiation in an Orthotopic Mouse Model of Head and Neck Squamous Cell Carcinoma. Mol Imaging Biol 2016; 17:633-42. [PMID: 25724406 PMCID: PMC4768231 DOI: 10.1007/s11307-015-0834-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose Hyperbaric oxygen therapy (HBOT) is used in the treatment of radiation-induced tissue injury but its effect on (residual) tumor tissue is indistinct and therefore investigated in this study. Procedures Orthotopic FaDu tumors were established in mice, and the response of the (irradiated) tumors to HBOT was monitored by bioluminescence imaging. Near infrared fluorescence imaging using AngioSense750 and Hypoxisense680 was applied to detect tumor vascular permeability and hypoxia. Results HBOT treatment resulted in accelerated growth of non-irradiated tumors, but mouse survival was improved. Tumor vascular leakiness and hypoxia were enhanced after HBOT, whereas histological characteristics, epithelial-to-mesenchymal transition markers, and metastatic incidence were not influenced. Conclusions Squamous cell carcinoma responds to HBOT with respect to tumor growth, vascular permeability, and hypoxia, which may have implications for its use in cancer patients. The ability to longitudinally analyze tumor characteristics highlights the versatility and potential of optical imaging methods in oncological research. Electronic supplementary material The online version of this article (doi:10.1007/s11307-015-0834-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joanna A M Braks
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Linda Spiegelberg
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Senada Koljenovic
- Department of Pathology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Yanto Ridwan
- Department of Genetics, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Stijn Keereweer
- Department of Otorhinolaryngology and Head & Neck Surgery, Erasmus Medical Center, PO Box 1738, 3015 CE, Rotterdam, Netherlands
| | - Roland Kanaar
- Department of Genetics, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiation Oncology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Eppo B Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jeroen Essers
- Department of Genetics, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Radiation Oncology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Vascular Surgery, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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10
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Ichikawa T, Otani Y, Kurozumi K, Date I. Phenotypic Transition as a Survival Strategy of Glioma. Neurol Med Chir (Tokyo) 2016; 56:387-95. [PMID: 27169497 PMCID: PMC4945597 DOI: 10.2176/nmc.ra.2016-0077] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Malignant glioma is characterized by rapid proliferation, invasion into surrounding central nervous system tissues, and aberrant vascularization. There is increasing evidence that shows gliomas are more complex than previously thought, as each tumor comprises considerable intratumoral heterogeneity with mixtures of genetically and phenotypically distinct subclones. Heterogeneity within and across tumors is recognized as a critical factor that limits therapeutic progress for malignant glioma. Recent genotyping and expression profiling of gliomas has allowed for the creation of classification schemes that assign tumors to subtypes based on similarity to defined expression signatures. Also, malignant gliomas frequently shift their biological features upon recurrence and progression. The ability of glioma cells to resist adverse conditions such as hypoxia and metabolic stress is necessary for sustained tumor growth and strongly influences tumor behaviors. In general, glioma cells are in one of two phenotypic categories: higher proliferative activity with angiogenesis, or higher migratory activity with attenuated proliferative ability. Further, they switch phenotypic categories depending on the situation. To date, a multidimensional approach has been employed to clarify the mechanisms of phenotypic shift of glioma. Various molecular and signaling pathways are involved in phenotypic shifts of glioma, possibly with crosstalk between them. In this review, we discuss molecular and phenotypic heterogeneity of glioma cells and mechanisms of phenotypic shifts in regard to the glioma proliferation, angiogenesis, and invasion. A better understanding of the molecular mechanisms that underlie phenotypic shifts of glioma may provide new insights into targeted therapeutic strategies.
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Affiliation(s)
- Tomotsugu Ichikawa
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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11
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Daruwalla J, Greish K, Malcontenti-Wilson C, Muralidharan V, Maeda H, Christophi C. Styrene maleic acid copolymer-pirarubicin induces tumor-selective oxidative stress and decreases tumor hypoxia as possible treatment of colorectal cancer liver metastases. Surgery 2015; 158:236-47. [PMID: 25999256 DOI: 10.1016/j.surg.2015.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 03/08/2015] [Accepted: 03/11/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pirarubicin, a derivative of doxorubicin, induces tumor destruction via the production of reactive oxygen species (ROS) but is associated with cardiotoxicity. As a macromolecule (conjugated to styrene-maleic acid [SMA]), SMA-pirarubicin is selective to tumors resulting in improved survival with decreased systemic toxicity. Tumor destruction is, however incomplete, and resistant cells at the periphery of the tumor contribute to recurrence. Tumor hypoxia is a major factor in tumor resistance. Understanding the effect of oxidative stress induced by SMA-pirarubicin on the tumor microenvironment may be key to overcoming resistance. This study investigated the pattern of ROS production and tumor hypoxia after treatment with SMA-pirarubicin in a murine model of colorectal liver metastases. METHODS Liver metastases were induced in male, CBA mice using a murine-derived colon cancer cell line. SMA-pirarubicin (maximum tolerated dose, 100 mg/kg) or pirarubicin, (maximum tolerated dose, 10 mg/kg) were administered intravenously 14 days after tumor induction. Systemic oxidative stress in serum, liver, and cardiac tissue was quantified using the thiobarbituric acid reactive substances assay. Flow cytometry and fluorescence microscopy were used to assess ROS production for 48 hours after treatment. Tumor hypoxia was quantified using immunohistochemistry for pimonidazole adducts. RESULTS SMA-pirarubicin (100 mg/kg) induced ROS exclusively in tumors with minimal levels in serum and cardiac tissue. ROS levels were induced in a time-dependent and dose-dependent manner optimal between 4 and 24 hours after drug administration. Although tumor hypoxia was decreased overall, residual tumor cells adjacent to patent vessels were hypoxic. CONCLUSION This study provides insight into the tumor microenvironment after chemotherapy. SMA-pirarubicin inhibits the growth of colorectal liver metastases by inducing ROS, which seems to be largely tumor selective. The temporal pattern of ROS production can be used to improve future dosing regimens. Furthermore, the observation that residual tumor cells are hypoxic clarifies the need for a multimodal approach with agents that can alter the hypoxic state to effect complete tumor destruction.
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Affiliation(s)
- Jurstine Daruwalla
- Department of Surgery, University of Melbourne, Austin Health, Victoria, Australia.
| | - Khaled Greish
- Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand; Department of Oncology, Suez Canal University, Ismaïlia, Egypt
| | | | | | - Hiroshi Maeda
- Institute of Drug Delivery Science, Sojo University, Kumamoto, Japan
| | - Chris Christophi
- Department of Surgery, University of Melbourne, Austin Health, Victoria, Australia
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12
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Doguchi H, Saio M, Kuniyoshi S, Matsuzaki A, Yoshimi N. The enhancing effects of hyperbaric oxygen on mouse skin carcinogenesis. J Toxicol Pathol 2014; 27:67-72. [PMID: 24791069 PMCID: PMC4000075 DOI: 10.1293/tox.2013-0046] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 12/05/2013] [Indexed: 12/29/2022] Open
Abstract
The effects of hyperbaric oxygen (HBO) on mouse skin two-stage chemical carcinogenesis were examined. Six-week-old inbred CD-1 female mice were divided into the following five groups: group 1, normoxia and application of 25 nmol 7,12-dimethylbenz[a]anthracene (DMBA) and 8.5 nmol 12-O-tetradecanoylphorbol-13-acetate (TPA) (n=19); group 2, HBO and DMBA/TPA (n=21); group 3, HBO and DMBA/acetone (n=3); group 4, normoxia and acetone (n=3); and group 5, non-treatment group (n=5). HBO was started at the same time as DMBA. Mice were euthanized at 23 weeks after the start of the experiment. Mice in group 2 showed the occurrence of tumors at 8 weeks after the beginning of the experiment, while the occurrence of tumors in mice in group 1 was observed beginning at 9 weeks. There was a difference in occurrence among low-grade papillomas, high-grade papillomas and SCCs in both groups 1 and 2 by the χ (2)-test at end of the experiment (p<0.05). The Ki-67 labeling indices of tumors revealed that the percentages of positive cells in low-grade papillomas in groups 1 and 2 were 15.27 ± 2.54% and 29.67 ± 2.82%, respectively (p<0.01). The results suggested that the tumors in group 2, which was treated with HBO, were more progressive than those in group 1, which was not treated with HBO. In this study, HBO accelerated tumor cell proliferation and advanced tumor progression in skin carcinogenesis by DMBA/TPA.
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Affiliation(s)
- Hiroshi Doguchi
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0125, Japan
| | - Masanao Saio
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0125, Japan
| | - Shimpei Kuniyoshi
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0125, Japan
| | - Akiko Matsuzaki
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0125, Japan
| | - Naoki Yoshimi
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0125, Japan
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13
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Abstract
The widespread use of HBO as an adjunctive treatment of diabetic foot ulcers has been founded on weak scientific evidence, but the consistency in positive outcomes in trials evaluating HBO on ulcer healing is noteworthy, not least as these results are in concert with data from in vitro and physiologic studies supporting the theoretical framework of HBO reversing hypoxia-induced abnormality. The long-term ulcer-healing rates of the nonrandomized controlled studies before the recent study by Margolis and colleagues, 77% with HBO versus 25% with standard treatment, are in concert with 1-year follow-up data from the 2 double-blind RCTs, 54% versus 25%. These 2 trials have put the use of HBO on firmer ground, but several issues, including health economics, developing robust selection criteria for treatment, optimizing treatment protocols, and identifying standards for when to start and stop treatment, remain to be elucidated. Not least, outcomes from further high-quality studies are needed. At present, HBO may be used as an adjunctive therapy in a select group of patients with diabetic foot ulcers that are difficult to heal.
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Affiliation(s)
- Magnus Löndahl
- Department of Clinical Sciences, Lund University, Lund S-221 85, Sweden.
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14
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Moen I, Stuhr LEB. Hyperbaric oxygen therapy and cancer--a review. Target Oncol 2012; 7:233-42. [PMID: 23054400 PMCID: PMC3510426 DOI: 10.1007/s11523-012-0233-x] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 09/20/2012] [Indexed: 02/06/2023]
Abstract
Hypoxia is a critical hallmark of solid tumors and involves enhanced cell survival, angiogenesis, glycolytic metabolism, and metastasis. Hyperbaric oxygen (HBO) treatment has for centuries been used to improve or cure disorders involving hypoxia and ischemia, by enhancing the amount of dissolved oxygen in the plasma and thereby increasing O2 delivery to the tissue. Studies on HBO and cancer have up to recently focused on whether enhanced oxygen acts as a cancer promoter or not. As oxygen is believed to be required for all the major processes of wound healing, one feared that the effects of HBO would be applicable to cancer tissue as well and promote cancer growth. Furthermore, one also feared that exposing patients who had been treated for cancer, to HBO, would lead to recurrence. Nevertheless, two systematic reviews on HBO and cancer have concluded that the use of HBO in patients with malignancies is considered safe. To supplement the previous reviews, we have summarized the work performed on HBO and cancer in the period 2004–2012. Based on the present as well as previous reviews, there is no evidence indicating that HBO neither acts as a stimulator of tumor growth nor as an enhancer of recurrence. On the other hand, there is evidence that implies that HBO might have tumor-inhibitory effects in certain cancer subtypes, and we thus strongly believe that we need to expand our knowledge on the effect and the mechanisms behind tumor oxygenation.
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Affiliation(s)
- Ingrid Moen
- Department of Biomedicine, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway.
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15
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Künzli BM, Bernlochner MI, Rath S, Käser S, Csizmadia E, Enjyoji K, Cowan P, d'Apice A, Dwyer K, Rosenberg R, Perren A, Friess H, Maurer CA, Robson SC. Impact of CD39 and purinergic signalling on the growth and metastasis of colorectal cancer. Purinergic Signal 2011; 7:231-41. [PMID: 21484085 DOI: 10.1007/s11302-011-9228-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2010] [Accepted: 03/07/2011] [Indexed: 12/14/2022] Open
Abstract
Despite improvements in prevention and management of colorectal cancer (CRC), uncontrolled tumor growth with metastatic spread to distant organs remains an important clinical concern. Genetic deletion of CD39, the dominant vascular and immune cell ectonucleotidase, has been shown to delay tumor growth and blunt angiogenesis in mouse models of melanoma, lung and colonic malignancy. Here, we tested the influence of CD39 on CRC tumor progression and metastasis by investigating orthotopic transplanted and metastatic cancer models in wild-type BALB/c, human CD39 transgenic and CD39 deficient mice. We also investigated CD39 and P2 receptor expression patterns in human CRC biopsies. Murine CD39 was expressed by endothelium, stromal and mononuclear cells infiltrating the experimental MC-26 tumors. In the primary CRC model, volumes of tumors in the subserosa of the colon and/or rectum did not differ amongst the treatment groups at day 10, albeit these tumors rarely metastasized to the liver. In the dissemination model, MC-26 cell line-derived hepatic metastases grew significantly faster in CD39 over-expressing transgenics, when compared to CD39 deficient mice. Murine P2Y2 was significantly elevated at both mRNA and protein levels, within the larger liver metastases obtained from CD39 transgenic mice where changes in P2X7 levels were also noted. In clinical samples, lower levels of CD39 mRNA in malignant CRC tissues appeared associated with longer duration of survival and could be linked to less invasive tumors. The modulatory effects of CD39 on tumor dissemination and differential levels of CD39, P2Y2 and P2X7 expression in tumors suggest involvement of purinergic signalling in these processes. Our studies also suggest potential roles for purinergic-based therapies in clinical CRC.
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Affiliation(s)
- Beat M Künzli
- Liver and Transplantation Centers, Beth Israel Deaconess Medical Center, Harvard University, Boston, USA,
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16
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Lin HY, Ku CH, Liu DW, Chao HL, Lin CS, Jen YM. Hyperbaric oxygen therapy for late radiation-associated tissue necroses: is it safe in patients with locoregionally recurrent and then successfully salvaged head-and-neck cancers? Int J Radiat Oncol Biol Phys 2009; 74:1077-82. [PMID: 19327913 DOI: 10.1016/j.ijrobp.2008.08.076] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Revised: 08/28/2008] [Accepted: 08/29/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE To test, in a retrospective matched-pair study, whether necrosis-rescuing hyperbaric oxygen therapy (HBOT) increases the risk of cancer re-recurrence in patients with locoregionally recurrent and then successfully salvaged head-and-neck cancers. METHODS AND MATERIALS Between January 1995 and July 2004, we retrospectively identified 22 patients with locoregionally recurrent and then successfully salvaged head-and-neck cancers. We defined two groups: the HBOT group, 11 patients with HBOT for rescuing late radiation-associated tissue necroses; and the non-HBOT group, the other 11 matched-pair patients without HBOT. Between the two groups, the following four factors were matched for case pairing: primary cancer subsite, initial cancer stage, age, and gender. RESULTS Three findings indicate that HBOT increases the risk of cancer re-recurrence. First, we observed more cancer re-recurrences in the HBOT group than in the non-HBOT group: 9 of 11 vs. 4 of 11, with 5-year disease-free survival rates after salvage of 32.7% vs. 70.0% (hazard ratio 3.2; 95% confidence interval 1.03-10.7; p = 0.048). Second, re-recurrences developed rapidly after HBOT in 6 patients. Third, 3 patients had unusual cancer re-recurrences after HBOT. Remarkably, of 9 patients with cancer re-recurrences in the HBOT group, 4 patients had cancer disease-free intervals of 9 months or less before HBOT. CONCLUSIONS Necrosis-rescuing HBOT should be given with caution in patients with locoregionally recurrent and then successfully salvaged head-and-neck cancers; if it cannot be omitted entirely, deferring HBOT 9 months or longer after cancer re-treatment may be prudent.
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Affiliation(s)
- Hon-Yi Lin
- Department of Radiation Oncology, Buddhist Tzu Chi General Hospital, Dalin Branch, Taiwan, Republic of China
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17
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Dayan F, Mazure NM, Brahimi-Horn MC, Pouysségur J. A dialogue between the hypoxia-inducible factor and the tumor microenvironment. CANCER MICROENVIRONMENT : OFFICIAL JOURNAL OF THE INTERNATIONAL CANCER MICROENVIRONMENT SOCIETY 2008; 1:53-68. [PMID: 19308685 PMCID: PMC2654353 DOI: 10.1007/s12307-008-0006-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Accepted: 02/12/2008] [Indexed: 12/19/2022]
Abstract
The hypoxia-inducible factor is the key protein responsible for the cellular adaptation to low oxygen tension. This transcription factor becomes activated as a result of a drop in the partial pressure of oxygen, to hypoxic levels below 5% oxygen, and targets a panel of genes involved in maintenance of oxygen homeostasis. Hypoxia is a common characteristic of the microenvironment of solid tumors and, through activation of the hypoxia-inducible factor, is at the center of the growth dynamics of tumor cells. Not only does the microenvironment impact on the hypoxia-inducible factor but this factor impacts on microenvironmental features, such as pH, nutrient availability, metabolism and the extracellular matrix. In this review we discuss the influence the tumor environment has on the hypoxia-inducible factor and outline the role of this factor as a modulator of the microenvironment and as a powerful actor in tumor remodeling. From a fundamental research point of view the hypoxia-inducible factor is at the center of a signaling pathway that must be deciphered to fully understand the dynamics of the tumor microenvironment. From a translational and pharmacological research point of view the hypoxia-inducible factor and its induced downstream gene products may provide information on patient prognosis and offer promising targets that open perspectives for novel "anti-microenvironment" directed therapies.
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Affiliation(s)
- Frédéric Dayan
- Institute of Signaling, Developmental Biology and Cancer Research, University of Nice, CNRS UMR 6543, Centre A. Lacassagne, 33 Avenue Valombrose, 06189 Nice, France
| | - Nathalie M. Mazure
- Institute of Signaling, Developmental Biology and Cancer Research, University of Nice, CNRS UMR 6543, Centre A. Lacassagne, 33 Avenue Valombrose, 06189 Nice, France
| | - M. Christiane Brahimi-Horn
- Institute of Signaling, Developmental Biology and Cancer Research, University of Nice, CNRS UMR 6543, Centre A. Lacassagne, 33 Avenue Valombrose, 06189 Nice, France
| | - Jacques Pouysségur
- Institute of Signaling, Developmental Biology and Cancer Research, University of Nice, CNRS UMR 6543, Centre A. Lacassagne, 33 Avenue Valombrose, 06189 Nice, France
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18
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Olascoaga A, Vilar-Compte D, Poitevin-Chacón A, Contreras-Ruiz J. Wound healing in radiated skin: pathophysiology and treatment options. Int Wound J 2008; 5:246-57. [PMID: 18494630 DOI: 10.1111/j.1742-481x.2008.00436.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Ulcers in radiated skin continue to be a challenge for health care practitioners. Healing impairment in the setting of radiation-damaged tissue will most of the time lead to chronic wounds that reduce the patient's quality of life. In this review, we present an update of the pathophysiology of tissue damage caused by radiation that leads to chronic ulceration. We also explore the evidence available on the different prevention and treatment modalities that have been reported in the literature. The evidence for most preventive measures is inconclusive; however, sucralfate and amifostine seem to be the adequate recommendations for prophylaxis. As for treatment of ulcerated patients, the strongest level of evidence found was for the use of pentoxifylline, but proper trials are still scarce to be considered standard adjuvant therapy. Hyperbaric oxygen, cytokines and other growth factors and surgical interventions have shown some benefit in case reports and case series only. Other therapies show promise based on their mechanism of action but need to be tested in human studies and clinical trials.
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Affiliation(s)
- Andrea Olascoaga
- Department of Dermatology, Dr Manuel Gea Gonzalez General Hospital, Mexico City, Mexico
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19
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Tang H, Sun Y, Xu C, Zhou T, Gao X, Wang L. Effects of hyperbaric oxygen therapy on tumor growth in murine model of PC-3 prostate cancer cell line. Urology 2008; 73:205-8. [PMID: 18579187 DOI: 10.1016/j.urology.2008.04.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Revised: 04/07/2008] [Accepted: 04/14/2008] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To test the hypothesis that hyperbaric oxygen (HBO) has no effect on tumor growth in a murine model of indolent in vivo prostate cancer. HBO means breathing pure (100%) oxygen under increased atmospheric pressure. METHODS Human prostate PC-3 cells were injected into 40 severe combined-immunodeficient mice. They were randomized to undergo 20 sessions of either HBO or normobaric air in standardized conditions and observed for 4 weeks before histologic assessment of any palpable tumors that had developed. The analysis of the developed PC-3 tumors included tumor volume, microvessel density, apoptosis-associated markers (ie, p53, p27), and the proliferative index (Ki-67). RESULTS The exposure to HBO at 2 atm for 20 treatment sessions, which comprised a daily 90-minute session, 5 d/wk, had no effect on the prostate cancer volume (P > .05). No differences were observed in tumor microvessel density, proliferative index, or apoptosis markers compared with the non-HBO group (P > .05). CONCLUSIONS HBO did not have a tumor stimulatory effect on prostate cancer and could potentially be used safely in conjunction with other therapeutic modalities.
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Affiliation(s)
- Hao Tang
- Department of Urology, Shanghai Changhai Hospital, Shanghai, China
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20
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Daruwalla J, Greish K, Nikfarjam M, Millar I, Malcontenti-Wilson C, Iyer AK, Christophi C. Evaluation of the effect of SMA-pirarubicin micelles on colorectal cancer liver metastases and of hyperbaric oxygen in CBA mice. J Drug Target 2007; 15:487-95. [PMID: 17671895 DOI: 10.1080/10611860701499839] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Tetrahydropyranyladriamycin (THP or pirarubicin) destroys tumors via several mechanisms; one of which involves the production of ROS that requires molecular oxygen for its generation. SMA forms stable self-assembled associated micelles with pirarubicin (SMA-pirarubicin), and confers macromolecular characteristics to pirarubicin. This micellar macromolecular drug is selectively delivered to solid tumors via the EPR effect and its preferential tumor accumulation suppresses the systemic toxicity whilst its prolonged high concentration at the site of tumor enhances its efficacy much higher compared to free pirarubicin. Administration of SMA-pirarubicin micelle under HBO can further enhance the delivery of molecular oxygen that facilitates tumor selective generation of ROS, thus augmenting its antitumor potency. In this study, we evaluated the efficacy of SMA-pirarubicin micelles either as single drug or in combination with HBO in a mouse metastatic colorectal cancer model. At or below the maximum tolerated dose, SMA-pirarubicin remarkably reduced metastatic tumor nodules and it was far more effective than free pirarubicin. The data also suggests a potential benefit of combined therapy of HBO with micellar anthracyclins.
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Affiliation(s)
- Jurstine Daruwalla
- Department of Surgery, Austin Health Hospital, University of Melbourne, Heidelberg, Vic., Australia
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