Endoscope-assisted brachytherapy for pancreatic cancer: From tumor killing to pain relief and drainage

Du, Yiqi; Li, Zhao‐Shen; Jin, Zhendong

doi:10.4161/jig.1.1.14596

Cited by 29 publications

(21 citation statements)

References 34 publications

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“…20 Our previous study also indicated that EUS-guided interstitial implantation of 125 I seeds could improve pain control in PC patients. 21,22 These results suggest that radiotherapy might destroy intrapancreatic nerve fibers. Considering that EUS-guided celiac ganglion neurolysis (EUS-CGN) and 125 I seed implantation are 2 established minimally invasive techniques, we hypothesized that combining them might allow precise and safe implantation of radioactive seeds in the human celiac ganglia to manage pain.…”

Section: Discussionmentioning

confidence: 92%

EUS-guided celiac ganglion irradiation with iodine-125 seeds for pain control in pancreatic carcinoma: a prospective pilot study

Wang

Jin

et al. 2012

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 92%

EUS-guided celiac ganglion irradiation with iodine-125 seeds for pain control in pancreatic carcinoma: a prospective pilot study

Wang

Jin

et al. 2012

Gastrointestinal Endoscopy

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“…Clinical experience has identified its profound resistance to extant treatments. Surgical resection remains the only chance for cure of PC patients as comprehensive treatment showed a less satisfactory effect on PC survival [2,3], and development of efficient early detection modality ranks the key project for oncologists. Extensive histopathological studies have evaluated pancreatic neoplasms and identified different precursor lesions as having the potential to evolve into highly malignant and invasive PC, including CP, pancreatic intraepithelial neoplasia (PanIN), mucinous cystic neoplasms and intraductal papillary mucinous neoplasms (IPMNs) [4,5].…”

Section: Recent Progress In Pcmentioning

confidence: 99%

Chronic Pancreatitis and Pancreatic Cancer

Kong¹,

Sun²,

Kong³

et al. 2014

Gastrointest Tumors

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Background: Pancreatic cancer (PC) is one of the most lethal diseases with an incidence rate almost equal to the rate of mortality. Chronic pancreatitis (CP) is a common chronic inflammatory disease of unknown etiology that affects the pancreas. Epidemiological studies have identified CP to be a major risk factor for PC. Summary: A greater understanding of the molecular mechanisms linking CP and PC has identified several common pathways that provide targets for future interventions. This article reviews those components in the CP-PC connection, including the role of macrophages, the maintenance of genome stability, cytokines, and other nodal factors such as nuclear factor kappa B, COX-2 and reactive oxygen species. Key Message: The molecular mechanisms that underlie CP and PC provide novel targets for future therapies for PC. Practical Implications: The stromal-desmoplastic reaction plays an important role in initiating and sustaining chronic inflammation and tumor progression. Recently, two targeted anti-tumor agents, erlotinib and nab-paclitaxel, have shown promising therapeutic efficacy. Notably, both these agents target components (EGFR and SPARC) within the inflammatory stroma surrounding malignant cells, underscoring the importance of inflammation in pancreatic carcinogenesis. Identifying the common pathways linking CP and PC may help uncover additional novel targets for future therapies.

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“…The prostate model results are particularly promising because all mice experienced over 95% tumor regression and 4 remained in full remission at the end of the 60 day observation period. Although pancreatic cancer is not commonly treated with brachytherapy, its dismal prognosis has stimulated new trials investigating neo-adjuvant and adjuvant options that could improve surgical outcomes [43–45]. In this context, the 131 I-ELP displays promising potential against the radiation resistant BxPc3-luc2 pancreatic tumor in a completely novel application of brachytherapy.…”

Section: Discussionmentioning

confidence: 99%

Injectable polypeptide micelles that form radiation crosslinked hydrogels in situ for intratumoral radiotherapy

Schaal

Mastria

et al. 2016

Journal of Controlled Release

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Intratumoral radiation therapy – ‘brachytherapy’ – is a highly effective treatment for solid tumors, particularly prostate cancer. Current titanium seed implants, however, are permanent and are limited in clinical application to indolent malignancies of low- to intermediate-risk. Attempts to develop polymeric alternatives, however, have been plagued by poor retention and off-target toxicity due to degradation. Herein, we report on a new approach whereby thermally sensitive micelles composed of an elastin-like polypeptide (ELP) are labeled with the radionuclide 131I to form an in situ hydrogel that is stabilized by two independent mechanisms: first, body heat triggers the radioactive ELP micelles to rapidly phase transition into an insoluble, viscous coacervate in under 2 minutes; second, the high energy β-emissions of 131I further stabilize the depot by introducing crosslinks within the ELP depot over 24 hours. These injectable brachytherapy hydrogels were used to treat two aggressive orthotopic tumor models in athymic nude mice: a human PC-3M-luc-C6 prostate tumor and a human BxPc3-luc2 pancreatic tumor model. The ELP depots retained greater than 52% and 70% of their radioactivity through 60 days in the prostate and pancreatic tumors with no appreciable radioactive accumulation (≤ 0.1% ID) in off-target tissues after 72 hours. The 131I-ELP depots achieved >95% tumor regression in the prostate tumors (n=8); with a median survival of more than 60 days compared to 12 days for control mice. For the pancreatic tumors, ELP brachytherapy (n=6) induced significant growth inhibition (p = 0.001, ANOVA) and enhanced median survival to 27 days over controls.

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Endoscope-assisted brachytherapy for pancreatic cancer: From tumor killing to pain relief and drainage

Cited by 29 publications

References 34 publications

EUS-guided celiac ganglion irradiation with iodine-125 seeds for pain control in pancreatic carcinoma: a prospective pilot study

EUS-guided celiac ganglion irradiation with iodine-125 seeds for pain control in pancreatic carcinoma: a prospective pilot study

Chronic Pancreatitis and Pancreatic Cancer

Injectable polypeptide micelles that form radiation crosslinked hydrogels in situ for intratumoral radiotherapy

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