PO.ET02.08 · 实验与分子治疗
电化学疗法作为局部控制犬棘皮瘤型成釉细胞瘤的创新药物递送方式
Electrochemotherapy as an innovative drug delivery modality for local control of canine acanthomatous ameloblastoma
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
引言：棘皮瘤型成釉细胞瘤是犬最常见的牙源性上皮肿瘤。整块切除是首选治疗，因为边缘切除的一年内复发率超过90%。电化学疗法（ECT）能够实现博来霉素的细胞内递送，诱导凋亡性细胞死亡。本研究旨在评估ECT治疗犬成釉细胞瘤的疗效、反应和并发症。
材料与方法：纳入12只经组织病理学确诊的口腔成釉细胞瘤犬。在所分析的病变中，9个小于2 cm，3个大于2 cm。所有患者均接受一或两次ECT治疗。在12例中的11例中，为优化肿瘤入路需要拔牙。治疗使用EPV-200电穿孔仪（Biotex，阿根廷）配合针电极进行。在施加电脉冲（一列8个100 μs脉冲，1000 V/cm，5000 Hz）前8分钟静脉给予博来霉素，剂量为15000 IU/m2。记录肿瘤反应、复发和治疗后并发症。
结果：75%（9/12）的病变小于2 cm。10位患者（83.3%）接受单次ECT，其余两位需要第二次治疗——一位在30天，另一位在95天——基于初始治疗反应。当电场完全覆盖整个肿瘤时，较小病变（<2cm）表现出更好的反应。在12例中的11例（91.6%）中，需要部分拔牙以确保肿瘤及其起源部位完全暴露。临床反应为：完全缓解83.3%（10/12），部分缓解8.3%（1/12），疾病稳定8.3%（1/12），随访期间无肿瘤进展病例。主要术后并发症为局部炎症（100%）和轻至中度疼痛（33.3%），二者均通过镇痛和抗炎治疗成功控制。
结论：电化学疗法是保守治疗犬成釉细胞瘤的一种有效且安全的替代方案。早期发现和治疗与更高的完全缓解率相关。拔除邻近牙齿通过增强电场与肿瘤组织的接触来提高治疗效果。治疗后疼痛和炎症的控制对于最大限度减少并发症和优化恢复至关重要。
查看英文原文 English abstract
Introduction: Acanthomatous ameloblastoma is the most common odontogenic epithelial tumor in dogs. Block excision is the treatment of choice since marginal removal has a recurrence rate exceeding 90% within one year. Electrochemotherapy (ECT) enables intracellular delivery of bleomycin, inducing apoptotic cell death. The aim of this study was to evaluate efficacy, response and complications of ECT in canine ameloblastomas.
Materials and Methods: Twelve dogs with histopathologically confirmed oral ameloblastoma were included. Of the lesions analyzed, nine were smaller than 2 cm and three were larger than 2 cm. All patients were treated with ECT in one or two sessions. In 11 of 12 cases, tooth extraction was required to optimize tumor access. Treatment was performed using an EPV-200 electroporator (Biotex, Argentina) with needle electrodes. Bleomycin was administered intravenously at a dose of 15000 IU/m 2 , eight minutes prior to delivering the electric pulses (train of eight 100 µs pulses, 1000 V/cm, 5000 Hz). Tumor response, recurrence and post treatment complications were recorded.
Results: Seventy-five percent (9/12) of the lesions were smaller than 2 cm. A single ECT session was performed in 10 patients (8.3.3%), while the remaining two required a second session- one at 30 days and another at 95 days- based on the initial treatment response. Smaller lesion (<2cm) showed better response when the entire tumor was covered by the electric field. In 11 of 12 cases (91.6%) partial tooth removal was necessary to ensure complete exposure of the tumor and its origin. Clinical responses were complete in 83.3% (10/12), partial in 8.3% (1/12), and stable disease in 8.3% (1/12), with no cases of tumor progression during the follow- up. The main postoperative complications were local inflammation (100%) and mild to moderate pain (33.3%), both managed successfully with analgesic and anti-inflammatory therapy.
Conclusions: Electrochemotherapy represents an effective and safe therapeutic alternative for the conservative management of canine ameloblastoma. Early detection and treatment are associated with higher complete response rates. Extraction of adjacent teeth improves treatment efficacy by enhancing electric field contact with the tumor tissue. Post treatment pain and inflammation control are essential to minimize complications and optimize recovery.
利益披露 Disclosure
S. F. Salgado, None..
A. H. Bazan, None..
J. D. Mestanza, None..
M. Vizquerra, None..
N. K. Candela, None..
M. Westreicher, None.