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Bai J, Yu Q, Wang Y, Xu L, Wang J, Zhai J, Bao Q, Guo W, Wu C, Zhang K, Shou W, Zhu G. Iodine-125 brachytherapy suppresses tumor growth and alters bone metabolism in a H1299 xenograft mouse model. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2023; 40:72. [PMID: 36607460 DOI: 10.1007/s12032-022-01937-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023]
Abstract
The present study aimed to investigate the efficacy of Iodine-125 (I-125) brachytherapy in a mouse model of non-small cell lung cancer, to further explore the efficacy and appropriate method of implantation of the I-125 radioactive seed. This study also aimed to determine the impact of brachytherapy on bone metabolism. A total of 18 mice were used to establish H1299 xenograft models, and were randomly assigned to three groups. These included non-radioactive seed implantation (Sham IM), fractionated I-125 seed implantation (Fractionated IM) and single I-125 seed implantation (Single IM) groups. Mice were euthanized after 28 days of implantation. H&E staining, Ki67 immunohistochemistry, CD31 morphometric analysis and TUNEL immunofluorescence assays were respectively used to determine the histopathological changes, proliferation, micro-angiogenesis and apoptosis of tumors. In addition, bone volume and microstructure were evaluated using trabecular bone area (Tb.Ar), trabecular thickness (Tb.Th), trabecular number (Tb.N) and cortical thickness. Bone metabolic status was analyzed using histomorphometric staining of tartrate-resistant acid phosphate (TRAP) and alkaline phosphatase (ALP) expression in the femur, and using an ELISA assay to determine the expression of C-telopeptide of type 1 collagen (CTX-1) and procollagen type 1 n-terminal propeptide (P1NP) in the serum. Moreover, reverse transcription-quantitative PCR and western blotting were carried out for the analysis of bone remodeling-related gene expression in the bone tissue. Results of the present study demonstrated that compared with the Sham IM group, both the I-125 seed implantation groups, including Fractionated IM and Single IM, demonstrated significant therapeutic effects in both tumor volume and weight. More specifically, the most significant therapeutic effects on tumor inhibition were observed in the Fractionated IM group. Results of Ki67 and CD31 immunohistochemical staining suggested a notable reduction in tumor cell proliferation and micro-angiogenesis, and results of the TUNEL assay demonstrated an increase in tumor cell apoptosis. Although the cortical bone appeared thinner and more fragile in both I-125 seed implantation groups, no notable adverse changes in the morphology of the cancellous bone were observed, and the index of Tb.Ar, Tb.Th and Tb.n was not significantly different among Sham IM and I-125 implantation groups. However, alterations in bone metabolism were characterized by a decrease in CTX-1 and P1NP expression, accompanied by an increase in TRAP activity and a decrease in ALP activity. Results of the present study also demonstrated the notable suppression of osteocalcin and runt-related transcription factor 2. I-125 seed implantation may be an effective and safe antitumor strategy. Moreover, the use of fractionated implantation patterns based on tumor shape exhibited improved therapeutic effect on tumor suppression when the total number of I-125 seeds was equivalent along with reduced complications associated with bone loss.
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Affiliation(s)
- Jiangtao Bai
- Institute of Radiation Medicine, Fudan University, Shanghai, China
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Qiquan Yu
- Longhua Hospital Affiliated to Shanghai TCM University, 725, South Wanping Road, Shanghai, China
| | - Yuyang Wang
- Institute of Radiation Medicine, Fudan University, Shanghai, China
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Linshan Xu
- Institute of Radiation Medicine, Fudan University, Shanghai, China
| | - Jianping Wang
- Institute of Radiation Medicine, Fudan University, Shanghai, China
| | - Jianglong Zhai
- Institute of Radiation Medicine, Fudan University, Shanghai, China
| | - Qi Bao
- Longhua Hospital Affiliated to Shanghai TCM University, 725, South Wanping Road, Shanghai, China
| | - Wentao Guo
- Longhua Hospital Affiliated to Shanghai TCM University, 725, South Wanping Road, Shanghai, China
| | - Chunxiao Wu
- Longhua Hospital Affiliated to Shanghai TCM University, 725, South Wanping Road, Shanghai, China
| | - Kun Zhang
- Longhua Hospital Affiliated to Shanghai TCM University, 725, South Wanping Road, Shanghai, China
| | - Weizhen Shou
- Longhua Hospital Affiliated to Shanghai TCM University, 725, South Wanping Road, Shanghai, China.
| | - Guoying Zhu
- Institute of Radiation Medicine, Fudan University, Shanghai, China.
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Wu N, Su X, Song H, Li Y, Gu F, Sun X, Li X, Cheng G. A Multi-Institutional Retrospective Analysis of Oncologic Outcomes for Patients With Locally Advanced Cervical Cancer Undergoing Platinum-Based Adjuvant Chemotherapy After Concurrent Chemoradiotherapy. Cancer Control 2021; 28:1073274821989307. [PMID: 33593091 PMCID: PMC8482744 DOI: 10.1177/1073274821989307] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective: To evaluated the oncologic outcomes associated with platinum-based adjuvant chemotherapy following concurrent chemoradiotherapy (CCRT) in the management of patients with locally advanced cervical cancer (LACC). Methods: A total of 695 patients with FIGO stage IB2, IIA2, IIB-IVA LACC treated at 6 medical facilities were enrolled and divided into 2 groups: 478 were assigned to CCRT alone (CCRT group) and 217 to adjuvant chemotherapy after CCRT (CCRT-ACT group). The treatment outcomes were retrospectively compared and reported after the propensity score matching (PSM) analysis. Results: With a median follow-up of 56.4 months, no statistically significant differences were found in overall survival (OS), disease-free survival (DFS), progression-free survival (PFS) and distance metastasis-free survival (DMFS) between 2 groups. In CCRT-ACT group, patients with lymph nodes involvement or squamous cell carcinoma (SCC) had significantly longer DMFS, but no significant benefit in survival outcomes were observed with more than 2 cycles of adjuvant chemotherapy. Moreover, patients with a high level of CA125 (>20.5U/mL) or SCC-Ag (>22.8μg/L) had a relatively better DFS or PFS, and grade 3-4 acute hematological toxicity, late urinary and lower gastrointestinal complications and diarrhea symptom were more frequent in CCRT-ACT group. Conclusions: Adjuvant chemotherapy after CCRT has a potential role in further improving disease control for LACC patients with lymph nodal-metastasis or SCC with a high level of CA125 or SCC-Ag. Due to increased treatment-related complications and diarrhea symptom affecting the quality of life, post-CCRT adjuvant chemotherapy with excessive cycles was not be considered as the most appropriate choice in general.
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Affiliation(s)
- Ning Wu
- Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xing Su
- Department of Radiation Oncology, Beijing Cancer Hospital, Beijing, China
| | - Honglin Song
- Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Ying Li
- Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fei Gu
- Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaoge Sun
- Department of Radiation Oncology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Xiaofan Li
- Department of Radiation Oncology, Beijing Cancer Hospital, Beijing, China
| | - Guanghui Cheng
- Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
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