J Cancer 2015; 6(3):218-226. doi:10.7150/jca.10970

Research Paper

Enhancement of Intratumoral Chemotherapy with Cisplatin with or without Microwave Ablation and Lipiodol. Future Concept for Local Treatment in Lung Cancer

Wolfgang Hohenforst-Schmidt1, Paul Zarogoulidis2✉, Joshua Stopek3, Efstratios Kosmidis4, Thomas Vogl5, Bernd Linsmeier6, Kosmas Tsakiridis7, Sofia Lampaki2, George Lazaridis8, Andreas Mpakas7, Robert Browning9, Antonis Papaiwannou2, Antonis Drevelegas10, Sofia Baka11, Vasilis Karavasilis8, Ioannis Mpoukovinas12, J Francis Turner13, Konstantinos Zarogoulidis2, Johannes Brachmann1

1. II Medical Clinic, “Coburg” Hospital, University of Wuerzburg, Coburg, Germany
2. Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
3. Covidien, U.S.A
4. Veterinary School, Aristotle University of Thessaloniki, Greece
5. Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Frankfurt, Germany
6. Department of Thoracic Surgery, Medinos Clinic Sonneberg, Sonnerberg, Germany
7. Department of Thoracic Surgery,”Saint Luke” Private Hospital, Panorama, Thessaloniki, Greece
8. Oncology Department, “Papageorgiou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
9. Pulmonary & Critical Care Medicine, Interventional Pulmonology, National Naval Medical Center, Walter Reed Army Medical Center, Bethesda, U.S.A
10. Radiology Department, “Interbalkan European Medical Center”, Τhessaloniki. Greece
11. Oncology Department, “Interbalkan European Medical Center”, Τhessaloniki. Greece
12. Oncology Department, “BioMedicine” Clinic, Thessaloniki, Greece
13. Division of Interventional Pulmonology & 2 Medical Oncology, Cancer Treatment Centers of America, Western Regional Medical Center, Goodyear, AZ

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Hohenforst-Schmidt W, Zarogoulidis P, Stopek J, Kosmidis E, Vogl T, Linsmeier B, Tsakiridis K, Lampaki S, Lazaridis G, Mpakas A, Browning R, Papaiwannou A, Drevelegas A, Baka S, Karavasilis V, Mpoukovinas I, Turner JF, Zarogoulidis K, Brachmann J. Enhancement of Intratumoral Chemotherapy with Cisplatin with or without Microwave Ablation and Lipiodol. Future Concept for Local Treatment in Lung Cancer. J Cancer 2015; 6(3):218-226. doi:10.7150/jca.10970. Available from http://www.jcancer.org/v06p0218.htm

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Novel therapies for lung cancer are being explored nowadays with local therapies being the tip of the arrow. Intratumoral chemotherapy administration and local microwave ablation have been investigated in several studies. It has been previously proposed that lipiodol has the ability to modify the microenvironment matrix. In our current study we investigated this theory in BALBC mice. In total 160 BALBC mice were divided in eight groups: a) control, b) cisplatin, c) microwave, d) microwave and lipiodol, e) cisplatin and lipiodol, f) microwave and cisplatin, g) lipiodol and h) lipiodol, cisplatin and microwave. Lewis lung carcinoma cell lines (106) were injected into the right back leg of each mouse. After the 8th day, when the tumor volume was about 100mm3 the therapy application was initiated, once per week for four weeks. Magnetic resonance imaging was performed for each tumor when a mouse died or when sacrificed if they were still alive by the end of the experiment (8-Canal multifunctional spool; NORAS MRI products, Gmbh, Germany). Imaging and survival revealed efficient tumor apoptosis for the groups b,c,d,e and f. However; severe toxicity was observed in group h and no follow up was available for this group after the second week of therapy administration. Lipiodol in its current form does assist in a more efficient way the distribution of cisplatin, as the microwave apoptotic effect. Future modification of lipiodol might provide a more efficient method of therapy enhancement. Combination of drug and microwave ablation is possible and has an efficient apoptotic effect.

Keywords: lung cancer, intratumoral, lipiodol, cisplatin, microwave ablation