Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors.
Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors.
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DOI：
10.1038/s41598-017-09371-2
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发表时间：
2017-08-18
影响因子：
4.6
通讯作者：
Ramanujam N
中科院分区：
文献类型：
--
作者：
Morhard R;Nief C;Barrero Castedo C;Hu F;Madonna M;Mueller JL;Dewhirst MW;Katz DF;Ramanujam N
虽然手术是癌症治疗的基础，但在低收入国家，手术的机会有限。在这里，我们描述了一种基于肿瘤内乙醇注射的低成本替代疗法的发展，适用于资源有限的环境。尽管基于乙醇的肿瘤消融治疗肝细胞癌是成功的，但需要多次治疗、注射大容量液体以及治疗非包膜肿瘤的疗效下降限制了其适用性。为了解决这些限制，我们研究了一种增强的乙醇消融策略，通过添加乙基纤维素来保留肿瘤内的乙醇。这增加了注入乙醇的粘度，并在暴露于含水肿瘤环境时形成乙醇基凝胶相。该技术首先通过组织模拟模型优化，使分布体积最大化。然后，对化学诱导的仓鼠颊袋上皮肿瘤进行处理。作为对照，注射四倍或四分之一肿瘤体积的纯乙醇分别诱导33%和0%的肿瘤完全消退。相比之下，注射四分之一肿瘤体积的乙基纤维素乙醇，100%的肿瘤完全消退。这些结果有助于证明强化乙醇消融作为一种新的和有效的替代手术治疗肿瘤的概念，与资源有限的环境相关。
While surgery is at the foundation of cancer treatment, its access is limited in low-income countries. Here, we describe development of a low-cost alternative therapy based on intratumoral ethanol injection suitable for resource-limited settings. Although ethanol-based tumor ablation is successful in treating hepatocellular carcinomas, the necessity for multiple treatments, injection of large fluid volumes, and decreased efficacy in treatment of non-capsulated tumors limit its applicability. To address these limitations, we investigated an enhanced ethanol ablation strategy to retain ethanol within the tumor through the addition of ethyl cellulose. This increases the viscosity of injected ethanol and forms an ethanol-based gel-phase upon exposure to the aqueous tumor environment. This technique was first optimized to maximize distribution volume, using tissue-simulating phantoms. Then, chemically-induced epithelial tumors in the hamster cheek pouch were treated. As controls, pure ethanol injections of either four times or one-fourth the tumor volume induced complete regression of 33% and 0% of tumors, respectively. In contrast, ethyl cellulose-ethanol injections of one-fourth the tumor volume induced complete regression in 100% of tumors. These results contribute to proof-of-concept for enhanced ethanol ablation as a novel and effective alternative to surgery for tumor treatment, with relevance to resource-limited settings.
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DOI：
10.1016/0030-4220(86)90421-4
发表时间：
1986-04-01
期刊：
ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTOLOGY
影响因子：
--
作者：
BURNS, RA;KLAUNIG, JE;GOLDBLATT, PJ
通讯作者：
GOLDBLATT, PJ
影响因子：
--
作者：
Kushner, Adam L.;Cherian, Meena N.;Etienne, Carissa
通讯作者：
Etienne, Carissa
影响因子：
5
作者：
Goldberg, SN;Gazelle, GS;Mueller, PR
通讯作者：
Mueller, PR
DOI：
10.1016/j.ijgo.2007.07.009
发表时间：
2008-01-01
影响因子：
3.8
作者：
Mariategui, J.;Santos, C.;Castle, P. E.
通讯作者：
Castle, P. E.
影响因子：
4.5
作者：
Hagopian, Amy;Thompson, Matthew J;Hart, L Gary
通讯作者：
Hart, L Gary