Visible tumor surface response to physical plasma and apoptotic cell kill in head and neck cancer

Schuster, Matthias; Seebauer, Christian; Rutkowski, Rico; Hauschild, Anna; Podmelle, Fred; Metelmann, Camilla; Metelmann, Bibiana; Woedtke, Thomas von; Hasse, Sybille; Weltmann, Klaus‐Dieter; Metelmann, Hans‐Robert

doi:10.1016/j.jcms.2016.07.001

Cited by 110 publications

(109 citation statements)

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“…4 Their potential therapeutic benefits were later explored for the treatment of chronic wounds, 5-8 ablation of non-neoplastic Barrett mucosa, 9 and other neoplastic disease. [10][11][12][13][14][15] Although the majority of published studies reported results obtained from laboratory-based experimental work, [16][17][18][19][20] a number of clinical trials involving patients treated with AP for neoplastic 9,21 or skin disease 22 have been reported. The management of acute and chronic wounds has emerged as one of the promising indications for the clinical use of APs because of their experimentally demonstrated properties, which have been shown to improve healing of stagnating, chronic, open wounds and to reduce bacterial burden in colonised or infected wounds.…”

Section: Introductionmentioning

confidence: 99%

Effects and safety of atmospheric low‐temperature plasma on bacterial reduction in chronic wounds and wound size reduction: A systematic review and meta‐analysis

Assadian

Ousey

Daeschlein

et al. 2018

International Wound Journal

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The use of atmospheric low‐temperature plasma (AP) on chronic wounds and its effect on microbial bioburden in open wounds has not been explored with a systematic review and meta‐analysis. PRISMA guidelines were followed and PubMed, Embase, CENTRAL, and CINAHL databases searched for randomised controlled trials (RCTs), which compared AP with no AP for the management of open, chronic wounds. The primary outcomes of reduction of bioburden or wound size were included. Meta‐analyses were performed; odds ratio (OR) and 95% confidence intervals (CIs) were extracted and pooled in a random effects model. Four RCTs investigated the effect of AP on chronic wound healing. Chronic wounds treated with AP did not show a significant improvement in healing (AP vs control: OR = 1.46; 95% CI = 0.89‐2.38; P = 0.13). Five further RCTs investigated the reduction of bioburden in wounds, but AP demonstrated no significant reduction of bioburden (AP vs control: OR = 0.85; 95% CI = 0.45‐1.62; P = 0.63). All nine RCTs recorded the presence of any severe adverse events (SAEs) in the 268 patients studied, with only one unrelated SAE identified in each group (AP vs control: OR = 1.00; 95% CI = 0.05‐19.96; P = 1.00). Use of AP in wound care is safe, but the retrieved evidence and meta‐analysis show that there is no clinical benefit of AP in chronic open wounds using currently available AP device settings.

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Section: Introductionmentioning

confidence: 99%

Effects and safety of atmospheric low‐temperature plasma on bacterial reduction in chronic wounds and wound size reduction: A systematic review and meta‐analysis

Assadian

Ousey

Daeschlein

et al. 2018

International Wound Journal

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“…This kind of medical care is usually very much appreciated by these patients because it reduces the strong fetid odour and pain and is not accompanied by serious side effects. Moreover, the application of CAP has been observed several times to cause visible changes of the tumour surface, similar to small and local regression . The following case presents the first real clinical benefit of a patient's plasma treatment, initially intended for palliative antimicrobial control only, which goes beyond just visible changes of the tumour surface:…”

Section: Introductionmentioning

confidence: 95%

“…There is consent among experts, referred to as EBM‐level IV, that in experimental settings, plasma kills various types of cancer, including melanoma, brain tumours, lung cancer, colon cancer, pancreatic cancer, breast cancer, leukaemia, thyroid cancer and head and neck cancer. Plasma treatment of head and neck cancer reaches the next stage, proof of concept by clinical pilot studies, EBM‐level III …”

Section: Introductionmentioning

confidence: 99%

“…In chemotherapy, the burden is, to some extent, the same as in radiotherapy; moreover, patients are suffering from fatigue caused by loss of red blood cells and low resistance against infections caused by loss of white blood cells. In plasma, there is currently no burden known and no severe and foreseeable side effects , . So, the discussion of plasma as a new option in cancer treatment has the perspective of a new approach at all, not only for the goal of anticancer effectiveness in special circumstances but for better safety, compatibility, and tolerability of cancer treatment in general.…”

Section: Introductionmentioning

confidence: 99%

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Treating cancer with cold physical plasma: On the way to evidence‐based medicine

Metelmann

Seebauer

Rutkowski

et al. 2018

Contributions to Plasma Physics

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The application of cold physical plasma in head and neck cancer patients is moving upwards in the pyramid of evidence‐based medicine (EBM). The effectiveness of plasma in cancer cell lines, cultivated human tumour cells, human tumour specimen freshly explanted from patients, animal model tumours, and animals with transplanted human tumour stem cells is well documented. There is consent among experts, referred to as EBM‐level IV, about the response to plasma in experimental settings and proof of concept by clinical pilot studies, EBM‐level III, for plasma treatment of head and neck cancer. If there is a manageable amount of tumour stem cells, like in precancerous lesions of oral mucosa or in small tumours like early basal cell carcinoma of the skin, plasma could become a clinical treatment option soon. Currently, it is already a concept in palliative care of patients with locally advanced head and neck cancer and contaminated ulcerations because of proven effectiveness against microbial pathogens. Patients greatly appreciate that plasma reduces strong fetid odour and pain while not being accompanied by serious side effects.

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“…Since it is ideally suited to the treatment of surfaces, the fields of plasma medicine and plasma cosmetics often target the skin, healthy or diseased. CAP is already employed in the treat-DOI: 10.1159/000505195 ment of chronic wounds [2][3][4] and tested for the treatment of superficial tumors [5], warts [6], and many other indications as well as for cosmetic applications, such as skin rejuvenation [7,8].…”

Section: Introductionmentioning

confidence: 99%

Plasma Permeabilization of Human Excised Full-Thickness Skin by µs- and ns-pulsed DBD

Gelker¹,

Müller‐Goymann²,

Viöl³

2020

Skin Pharmacol Physiol

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Introduction: Cold atmospheric plasma (CAP) is gaining increasing importance as a medical or cosmetic treatment for various indications. The technology is best suited to the treatment of surfaces such as the skin and is already used in wound care and, in exemplary case studies, the reduction of superficial tumors. Several plasma sources have been reported to affect the skin barrier function and potentially enable drug delivery across or into plasma-treated skin. Objective: In this study, this effect was quantified for different plasma sources in order to elucidate the influence of voltage rise time, pulse duration, and power density in treatments of fullthickness skin. Methods: We compared three different dielectric barrier discharges (DBDs) as to their permeabilization efficiency using Franz diffusion cell permeation experiments and measurements of the transepithelial electrical resistance (TEER) with full-thickness human excised skin. Results: We found a significant reduction of the TEER for all three plasma sources. Permeation of the hydrophilic sodium fluorescein molecule was enhanced by a factor of 11.7 (low power) to 41.6 (high power) through µs-pulsed DBD-treated skin. A smaller effect was observed after treatment with the ns-pulsed DBD. Conclusions: The direct treatment of excised human full-thickness skin with CAP, specifically a DBD, can lead to pore formation and enhances transdermal transport of sodium fluorescein.

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Visible tumor surface response to physical plasma and apoptotic cell kill in head and neck cancer

Cited by 110 publications

References 58 publications

Effects and safety of atmospheric low‐temperature plasma on bacterial reduction in chronic wounds and wound size reduction: A systematic review and meta‐analysis

Effects and safety of atmospheric low‐temperature plasma on bacterial reduction in chronic wounds and wound size reduction: A systematic review and meta‐analysis

Treating cancer with cold physical plasma: On the way to evidence‐based medicine

Plasma Permeabilization of Human Excised Full-Thickness Skin by µs- and ns-pulsed DBD

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