PO.ET02.08 · 实验与分子治疗
电化学疗法治疗直肠腺癌：通过电穿孔推进药物递送
Electrochemotherapy for rectal adenocarcinoma: Advancing drug delivery through electroporation
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
引言：直肠腺癌是犬下消化道最常见的肿瘤，影响生活质量。电化学疗法（ECT）是一种新型药物递送系统，通过短暂通透化细胞膜来增强低通透性细胞抑制药物的细胞内递送。本研究旨在评估ECT作为犬结直肠腺癌治疗手段的效果。
实验步骤：纳入12只确诊为直肠腺癌的犬。对每位患者记录的数据包括品种、性别、肿瘤大小、治疗次数、临床反应、复发、无病间期和治疗后并发症。治疗方案包括静脉给予博来霉素（15,000 IU/m2）。在直肠黏膜放置牵引点以便暴露待治疗病变。给药8分钟后，使用Biotex EPV200电穿孔仪（阿根廷）施加电脉冲。使用针状和板状电极施加一列8个单相脉冲（1000V/cm，5000Hz）。
结果：这是首项评估ECT治疗犬直肠腺癌的研究。大多数肿瘤为带蒂且小于1cm（9/12）；其余为宽基底，其中一例累及几乎整个直肠周径。所有病变均位于肛门3cm以内。所有犬（12/12）均接受单次治疗，完全缓解率达100%。12只犬中有10只在研究结束时保持无病状态；一只在两年后死于无关原因，两只出现局部复发（分别在308天和688天），后者经再次治疗成功，至今无病，生存期超过1350天。观察到的并发症包括局部炎症和里急后重；两例报告了疼痛和便秘。
结论：通过电穿孔递送博来霉素治疗犬直肠腺癌被证明有效，可视为手术的一线替代方案。建议制定全面的医疗管理计划以应对治疗后并发症。
查看英文原文 English abstract
Introduction: Rectal adenocarcinoma is the most common tumor of the lower digestive tract of the dogs, affecting the quality of life. Electrochemotherapy (ECT) is a novel drug delivery system that enhances the intracellular delivery of low-permeability cytostatic drug through the transient permeabilization of the cell membrane. This study aimed to evaluate ECT as a treatment for colorectal adenocarcinoma in dogs
Experimental procedure: Twelve dogs diagnosed with rectal adenocarcinoma were included. For each patient, data recorded included, breed, sex, tumor size, number of treatment sessions, clinical response, recurrence, disease-free interval and post treatment complications. The therapeutic protocol consisted in intravenous administration of Bleomycin (15,000 IU/m2). Traction points were placed in the rectal mucosa to facilitate exposure of the lesion to be treated. Eight minutes after drug administration, electric pulses were delivered using a Biotex EPV200 electroporator (Argentina). A train of eight monophasic pulses (1000V/cm, 5000Hz) was applied using needle and plate electrodes.
Results: This is the first study in dogs evaluating ECT for rectal adenocarcinoma. Most tumors were pedunculated and smaller than 1cm (9/12).; the remaining were broad-based, with one case involving nearly the entire rectal circumference. All lesions were located within 3cm of the anus. All dogs (12/12) underwent a single treatment session, achieving a 100% complete response rate. Ten of twelve dogs remained disease-free at the end of the study; one died of unrelated causes after two years, and two showed local recurrence (at 308 and 688 days, respectively), the latter successfully retreated and disease-free to date, with survival exceeding 1350 days. Observed complications included local inflammation and tenesmus; pain and constipation were reported in two cases.
Conclusion: Bleomycin delivered by electroporation for rectal adenocarcinoma in dogs proved to be effective and can be considered a first-line alternative to surgery. A comprehensive medical management plan is recommended to address post treatment complications.
利益披露 Disclosure
S. F. Salgado, None..
J. D. Mestanza, None..
M. Vizquerra, None..
M. Westreicher, None..
N. K. Candela, None..
A. H. Bazan, None.