Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors

Abstract While surgery is at the foundation of cancer treatment, its access is limited in low-income countries. Here, we describe development of a low-cost alternative therapy based on intratumoral ethanol injection suitable for resource-limited settings. Although ethanol-based tumor ablation is suc...

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Autores principales:	Robert Morhard, Corrine Nief, Carlos Barrero Castedo, Fangyao Hu, Megan Madonna, Jenna L. Mueller, Mark W. Dewhirst, David F. Katz, Nirmala Ramanujam
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/584c311f91c847edabf9b9ce015fe3e2
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spelling	oai:doaj.org-article:584c311f91c847edabf9b9ce015fe3e22021-12-02T12:32:08ZDevelopment of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors10.1038/s41598-017-09371-22045-2322https://doaj.org/article/584c311f91c847edabf9b9ce015fe3e22017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-09371-2https://doaj.org/toc/2045-2322Abstract While surgery is at the foundation of cancer treatment, its access is limited in low-income countries. Here, we describe development of a low-cost alternative therapy based on intratumoral ethanol injection suitable for resource-limited settings. Although ethanol-based tumor ablation is successful in treating hepatocellular carcinomas, the necessity for multiple treatments, injection of large fluid volumes, and decreased efficacy in treatment of non-capsulated tumors limit its applicability. To address these limitations, we investigated an enhanced ethanol ablation strategy to retain ethanol within the tumor through the addition of ethyl cellulose. This increases the viscosity of injected ethanol and forms an ethanol-based gel-phase upon exposure to the aqueous tumor environment. This technique was first optimized to maximize distribution volume, using tissue-simulating phantoms. Then, chemically-induced epithelial tumors in the hamster cheek pouch were treated. As controls, pure ethanol injections of either four times or one-fourth the tumor volume induced complete regression of 33% and 0% of tumors, respectively. In contrast, ethyl cellulose-ethanol injections of one-fourth the tumor volume induced complete regression in 100% of tumors. These results contribute to proof-of-concept for enhanced ethanol ablation as a novel and effective alternative to surgery for tumor treatment, with relevance to resource-limited settings.Robert MorhardCorrine NiefCarlos Barrero CastedoFangyao HuMegan MadonnaJenna L. MuellerMark W. DewhirstDavid F. KatzNirmala RamanujamNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-12 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Robert Morhard Corrine Nief Carlos Barrero Castedo Fangyao Hu Megan Madonna Jenna L. Mueller Mark W. Dewhirst David F. Katz Nirmala Ramanujam Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors
description	Abstract While surgery is at the foundation of cancer treatment, its access is limited in low-income countries. Here, we describe development of a low-cost alternative therapy based on intratumoral ethanol injection suitable for resource-limited settings. Although ethanol-based tumor ablation is successful in treating hepatocellular carcinomas, the necessity for multiple treatments, injection of large fluid volumes, and decreased efficacy in treatment of non-capsulated tumors limit its applicability. To address these limitations, we investigated an enhanced ethanol ablation strategy to retain ethanol within the tumor through the addition of ethyl cellulose. This increases the viscosity of injected ethanol and forms an ethanol-based gel-phase upon exposure to the aqueous tumor environment. This technique was first optimized to maximize distribution volume, using tissue-simulating phantoms. Then, chemically-induced epithelial tumors in the hamster cheek pouch were treated. As controls, pure ethanol injections of either four times or one-fourth the tumor volume induced complete regression of 33% and 0% of tumors, respectively. In contrast, ethyl cellulose-ethanol injections of one-fourth the tumor volume induced complete regression in 100% of tumors. These results contribute to proof-of-concept for enhanced ethanol ablation as a novel and effective alternative to surgery for tumor treatment, with relevance to resource-limited settings.
format	article
author	Robert Morhard Corrine Nief Carlos Barrero Castedo Fangyao Hu Megan Madonna Jenna L. Mueller Mark W. Dewhirst David F. Katz Nirmala Ramanujam
author_facet	Robert Morhard Corrine Nief Carlos Barrero Castedo Fangyao Hu Megan Madonna Jenna L. Mueller Mark W. Dewhirst David F. Katz Nirmala Ramanujam
author_sort	Robert Morhard
title	Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors
title_short	Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors
title_full	Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors
title_fullStr	Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors
title_full_unstemmed	Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors
title_sort	development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/584c311f91c847edabf9b9ce015fe3e2
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Development of enhanced ethanol ablation as an alternative to surgery in treatment of superficial solid tumors

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