Image-Guided Chemotherapy and Radiofrequency Ablation

描述（由申请人提供）： 拟议的工作重点是优化和有效性评估的图像引导治疗方法，利用破坏组织的热（以射频能量的形式提供），然后从聚合物基质持续释放化疗药物。将在图像引导下持续进行热量输送和药物-聚合物结构的注射，并将通过使用功能性X射线计算机断层扫描（CT）研究治疗病变的灌注来部分评价治疗的疗效。这种两种渐进但有些争议的技术-射频消融和局部药物输送-的整合创建了一个联盟，突出了两种方法的优点和缺点，并对患者保持微创。使用这种技术的有限初步实验已经显示出在实现改善的肿瘤控制方面有希望的结果，但也揭示了在这种治疗可以用于临床之前需要解决的许多问题。目前研究的重点是完善该方法，为初步临床研究做准备。这将通过实现三个主要目标来完成：1）通过比较两种递送基质-固体聚合物植入物和可注射聚合物凝胶来优化化疗药物向消融病变的递送; 2）开发和改进递送双模式治疗的图像引导经皮方法; 3）在兔肿瘤模型中系统地确定体内综合治疗的长期功效。

DESCRIPTION (provided by applicant): The proposed work focuses on optimization and efficacy assessment of an image-guided treatment approach utilizing destruction of tissue by heat (delivered in the form of radiofrequency energy) followed by sustained release of chemotherapeutic agents from a polymer matrix. Both the delivery of heat and injection of the drug-polymer construct will be performed percutaneously under image-guidance, and the efficacy of the treatment will be evaluated in part by using functional X-ray computed tomography (CT) to study the perfusion of treated lesions. This integration of two progressive yet somewhat controversial techniques - radiofrequency ablation and local drug delivery -- creates a union that highlights the strengths and addresses the shortcomings of both approaches and remains minimally invasive to the patient. Limited preliminary experiments with this technique have shown promising results in achieving improved tumor control, but have also revealed a number of issues that need to be addressed before this treatment can be used clinically. The focus of the current study is to perfect the approach in preparation for pilot clinical studies. This will be done by achieving three primary goals: 1) Optimizing the delivery of a chemotherapeutic drug to the ablated lesion by comparing two delivery matrixes - solid polymer implants and injectable polymer gels; 2) Developing and refining the image guided percutaneous approaches of delivering the dual-mode treatment; 3) Methodically determining the long-term efficacy of the integrated treatment in vivo in a rabbit tumor model.