Effect of thermal dose on heat shock protein expression after radio-frequency ablation with and without adjuvant nanoparticle chemotherapies

Abstract Purpose: The aim of this study was to evaluate the effect of different radio-frequency ablation (RFA) thermal doses on coagulation and heat shock protein (HSP) response with and without adjuvant nanotherapies. Materials and methods: First, Fischer rats were assigned to nine different thermal doses of hepatic RFA (50–90 °C, 2–20 min, three per group) or no treatment (n = 3). Next, five of these RF thermal doses were combined with liposomal-doxorubicin (Lipo-Dox, 1 mg intravenously) in R3230 breast tumours, or no tumour treatment (five per group). Finally, RFA/Lipo-Dox was given without and with an Hsp70 inhibitor, micellar quercetin (Mic-Qu, 0.3 mg intravenously) for two different RFA doses with similar coagulation but differing peri-ablational Hsp70 (RFA/Lipo-Dox at 70 °C × 5 min and 90 °C × 2 min, single tumours, five per group). All animals were sacrificed 24 h post-RFA and gross tissue coagulation and Hsp70 (maximum rim thickness and % cell positivity) were correlated to thermal dose including cumulative equivalent minutes at 43 °C (CEM43). Results: Incremental increases in thermal dose (CEM43) correlated to increasing liver tissue coagulation (R2 = 0.7), but not with peri-ablational Hsp70 expression (R2 = 0.14). Similarly, increasing thermal dose correlated to increasing R3230 tumour coagulation for RF alone and RFA/Lipo-Dox (R2 = 0.7 for both). The addition of Lipo-Dox better correlated to increasing Hsp70 expression compared to RFA alone (RFA: R2 = 0.4, RFA/Lipo-Dox: R2 = 0.7). Finally, addition of Mic-Qu to two thermal doses combined with Lipo-Dox resulted in greater tumour coagulation (p < 0.0003) for RFA at 90 °C × 2 min (i.e. greater baseline Hsp70 expression) than an RFA dose that produced similar coagulation but less HSP expression (p < 0.0004). Conclusion: Adjuvant intravenous Lipo-Dox increases peri-ablational Hsp70 expression in a thermally dependent manner. Such expression can be exploited to produce greater tumour destruction when adding a second adjuvant nanodrug (Mic-Qu) to suppress peri-ablational HSP expression.

[1]  José Irving Hernández,et al.  Microwave ablation: state-of-the-art review , 2015, OncoTargets and therapy.

[2]  M. Lee,et al.  Ablation of hepatocellular carcinoma. , 2014, Best practice & research. Clinical gastroenterology.

[3]  Bruno D Fornage,et al.  Current status of imaging-guided percutaneous ablation of breast cancer. , 2014, AJR. American journal of roentgenology.

[4]  S. Ferretti,et al.  Radiofrequency thermal ablation of renal tumors , 2014, La radiologia medica.

[5]  B. Abdullah,et al.  Phase 3, randomized, double-blind, dummy-controlled, trial of radiofrequency ablation (RFA) + lyso-thermosensitive liposomal doxorubicin (LTLD, Thermodox), for hepatocellular carcinoma (HCC) lesions 3-7 cm , 2014 .

[6]  V. Salapura,et al.  Minimally invasive (percutaneous) treatment of metastatic spinal and extraspinal disease--a review. , 2014, Acta clinica Croatica.

[7]  Theodoros Samaras,et al.  CEM43°C thermal dose thresholds: a potential guide for magnetic resonance radiofrequency exposure levels? , 2013, European Radiology.

[8]  J. Machan,et al.  Cost and effectiveness of radiofrequency ablation versus limited surgical resection for stage I non-small-cell lung cancer in elderly patients: is less more? , 2013, Journal of vascular and interventional radiology : JVIR.

[9]  Luigi Solbiati,et al.  Small liver colorectal metastases treated with percutaneous radiofrequency ablation: local response rate and long-term survival with up to 10-year follow-up. , 2012, Radiology.

[10]  S. Goldberg,et al.  Combination radiofrequency (RF) ablation and IV liposomal heat shock protein suppression: reduced tumor growth and increased animal endpoint survival in a small animal tumor model. , 2012, Journal of controlled release : official journal of the Controlled Release Society.

[11]  L. McManus,et al.  Chemoradionuclide therapy with 186Re-labeled liposomal doxorubicin in combination with radiofrequency ablation for effective treatment of head and neck cancer in a nude rat tumor xenograft model. , 2011, Radiology.

[12]  S. Goldberg,et al.  Radiofrequency ablation combined with liposomal quercetin to increase tumour destruction by modulation of heat shock protein production in a small animal model , 2011, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[13]  M. Dewhirst,et al.  Thresholds for thermal damage to normal tissues: An update , 2011, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[14]  P. V. van Diest,et al.  Radiofrequency ablation of colorectal liver metastases induces an inflammatory response in distant hepatic metastases but not in local accelerated outgrowth , 2010, Journal of surgical oncology.

[15]  K. Tatsch,et al.  Radiofrequency ablation after selective internal radiation therapy with Yttrium90 microspheres in metastatic liver disease-Is it feasible? , 2010, European journal of radiology.

[16]  S. Goldberg,et al.  Liposomal doxorubicin increases radiofrequency ablation-induced tumor destruction by increasing cellular oxidative and nitrative stress and accelerating apoptotic pathways. , 2010, Radiology.

[17]  I. Chang,et al.  Considerations for Thermal Injury Analysis for RF Ablation Devices , 2010, The open biomedical engineering journal.

[18]  Manabu Watanabe,et al.  Analysis of patients with rapid aggressive tumor progression of hepatocellular carcinoma after percutaneous radiofrequency ablation. , 2009, Hepato-gastroenterology.

[19]  C. Bokemeyer,et al.  A systematic review on the clinical benefit and role of radiofrequency ablation as treatment of colorectal liver metastases. , 2009, European journal of cancer.

[20]  G. Cabibbo,et al.  Multimodal approaches to the treatment of hepatocellular carcinoma , 2009, Nature Clinical Practice Gastroenterology &Hepatology.

[21]  M. Dewhirst,et al.  Radiofrequency ablation: The effect of distance and baseline temperature on thermal dose required for coagulation , 2008, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[22]  J. Cohen,et al.  Issues Critical to the Successful Application of Cryosurgical Ablation of the Prostate , 2007, Technology in cancer research & treatment.

[23]  L. Carotenuto,et al.  FEM analysis of RF breast ablation: multiprobe versus cool-tip electrode. , 2007, Anticancer research.

[24]  J. Bowsher,et al.  Intertumoral differences in hypoxia selectivity of the PET imaging agent 64Cu(II)-diacetyl-bis(N4-methylthiosemicarbazone). , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[25]  Guy Marchal,et al.  Local Recurrence After Hepatic Radiofrequency Coagulation: Multivariate Meta-Analysis and Review of Contributing Factors , 2005, Annals of surgery.

[26]  S. Goldberg,et al.  Combination radiofrequency ablation with intratumoral liposomal doxorubicin: effect on drug accumulation and coagulation in multiple tissues and tumor types in animals. , 2005, Radiology.

[27]  S. Goldberg,et al.  Reduced tumor growth with combined radiofrequency ablation and radiation therapy in a rat breast tumor model. , 2005, Radiology.

[28]  Yi-Cheng Chen,et al.  Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma < or =4 cm. , 2004, Gastroenterology.

[29]  F. Marshall Radiofrequency Ablation: Effect of Surrounding Tissue Composition on Coagulation Necrosis in a Canine Tumor Model , 2004 .

[30]  Robert E Lenkinski,et al.  Radiofrequency ablation: effect of surrounding tissue composition on coagulation necrosis in a canine tumor model. , 2004, Radiology.

[31]  Muneeb Ahmed,et al.  Radiofrequency ablation of hepatic tumors: increased tumor destruction with adjuvant liposomal doxorubicin therapy. , 2002, AJR. American journal of roentgenology.

[32]  S. Goldberg,et al.  Dynamic intrahepatic flow and cellular alterations during radiofrequency ablation of liver tissue in mice. , 2001, Journal of vascular and interventional radiology : JVIR.

[33]  S. Singletary,et al.  Radiofrequency ablation of solid tumors. , 2001, Cancer journal.

[34]  Chieko Azuma,et al.  Using units of CEM 43°C T90, local hyperthermia thermal dose can be delivered as prescribed , 2000 .

[35]  E. Patterson,et al.  Radiofrequency ablation followed by resection of malignant liver tumors. , 1999, American journal of surgery.

[36]  S L Dawson,et al.  Tissue ablation with radiofrequency: effect of probe size, gauge, duration, and temperature on lesion volume. , 1995, Academic radiology.

[37]  W. Dewey,et al.  Thermal dose determination in cancer therapy. , 1984, International journal of radiation oncology, biology, physics.

[38]  C. Tang,et al.  Radiofrequency ablation versus hepatic resection for hepatocellular carcinoma within the Milan criteria--a comparative study. , 2013, International Journal of Surgery.

[39]  M. Choi,et al.  Ten-year outcomes of percutaneous radiofrequency ablation as first-line therapy of early hepatocellular carcinoma: analysis of prognostic factors. , 2013, Journal of hepatology.

[40]  J W Hunt,et al.  Differential thermal sensitivity of tumour and normal tissue microvascular response during hyperthermia. , 1992, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.