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Doctoral Thesis
DOI
10.11606/T.5.2008.tde-25062008-160623
Document
Author
Full name
Sérgio Mendes
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2008
Supervisor
Committee
Maranhao, Raul Cavalcante (President)
Bagnoli, Vicente Renato
Brenelli, Henrique Benedito
Fonseca, Angela Maggio da
Piato, Sebastião
Title in Portuguese
Captação pelo carcinoma de mama e pelo linfonodo axilar de uma nanoemulsão lipídica administrada por injeção no tecido mamário locorregional
Keywords in Portuguese
Li-poproteínas LDL
Nanoparticulas lipídicas
Neoplasia mamária
Quimioterapia
Abstract in Portuguese
Em trabalhos anteriores, mostrou-se que uma nanoemulsão lipídica denomi-nada LDE após injeção endovenosa, em pacientes com carcinoma mamário e outros tumores sólidos concentra-se nos tecidos neoplásicos e pode direcionar especificamente agentes quimioterápicos ao tumor. Estudos clínicos mostraram que a LDE diminui acentuadamente os efeitos tóxicos desses agentes e em estudos com animais de experimentação não reduz seus efeitos antitumorais. No presente estudo, testamos a hipótese de a LDE injetada por via locorregional poderia concentrar-se no tumor de mama e nos linfonodos axilares da mama comprometida, visando futuras aplica-ções do sistema na quimioterapia neoadjuvante desse tumor. Três técnicas de injeção da LDE foram testadas em pacientes com carcinoma de mama avançado com tratamento cirúrgico pré-programado. A LDE marcada com colesterol radioativo foi injetada 12 horas antes da cirurgia, nas pacientes divididas em três grupos: Grupo 1 (G1, n=4): LDE injetada no parênquima mamário, a 5 cm da lesão ; Grupo 2 (G2, n=4): LDE injetada na região peri-tumoral; e Grupo 3 (G3 n=6): LDE injetada em região intratumoral. Este grupo foi subdividido em 2: em 2 pacientes realizaram cirurgia 2hs após a injeção da LDE e nas outras 4, 12hs após a injeção da LDE. Quantificou-se a capta-ção da LDE nos fragmentos de tecido tumoral e mamário normal e do linfonodo axilar retirados durante a cirurgia por contagem de radioatividade após extração lipídica dos tecidos. Os resultados evidenciaram que, em G1, houve maior captação da LDE em tecido normal, sugerindo se tratar de metodologia ina-dequada. Em G2, a captação da LDE foi quatro vezes maior no tecido tumo-ral do que no tecido normal, próximo, portanto, dos valores encontrados em estudos anteriores que utilizaram a injeção da LDE por via hematológica. Em G3, o valor médio de captação da LDE foi 53 vezes maior no tecido tumoral (>75%), com mínima captação pelo tecido mamário normal (<8%). A injeção intratumoral da LDE mostrou-se, portanto, metodologia ainda superior à inje-ção da LDE por via endovenosa para a utilização efetiva dessa nanoemulsão como terapia-alvo em tumores primários de mama.
Title in English
Capture by breast carcinoma and the axillary lymph node of a lipidic nanoemulsion injected into the locoregional breast tissue
Keywords in English
Breast cancer
Chemotherapy
LDL lipoprotein
Lipidic nanoemulsion
Abstract in English
In previous work had showed that a lipidic nanoemulsion called LDE after intravenous injection in patients with breast carcinoma and others solid tumors focuses in the neoplasic tissue and can target especially chemotherapist agents to the tumors. Clinical studies showed that LDE decreases the toxic effects of those agents and in studies with experimental animals don't reduce yours antitumoral effects. In the present study, we had test the hypothesis of the LDE injected by locoregional could focuses in the breast tumor and in the axillary lymph node of the compromised breast, targeting future applications of the system in the neoadjuvant chemotherapy of this tumor. Three techniques of injection of the LDE had test in patients with advanced breast carcinoma with sirurgic treatment pre-programmed. The LDE marked with radioactive cholesterol was injected 12 hours before the surgery, in patients divided in three groups: Group 1 (G1, n=4): LDE injected in the breast parenchyma, about 5 cm of the lesion; Group 2 (G2, n=4): LDE injected in the peritumoral region; and Group 3 (G3, n=6): LDE injected in the intratumoral region. This group was subdivided in 2: in 2 patients had realized surgery 2 hs after the injection of LDE and in the others 4 patients 12hs after the injection of LDE. It had quantified the capture of LDE in the fragments of the tumoral and breast tissue and of the axillary lymph node withdrawn during the surgery by counting of radioactive after lipidic extraction of this tissue. The results showed that, in G1, there was greater capture of LDE in normal tissue, suggesting it is an inappropriate methodology. In G2, the capture of LDE was four times higher in the tumoral tissue than in the normal tissue, closer, therefore, of the values found in previous studies that used the injection of LDE by hematology. In G3, the medium value of capture of LDE was 53 times higher in the tumoral tissue (> 75%), with minimum capture by the normal breast tissue (< 8%). The intratumoral injection of LDE showed, therefore, methodology still higher than the intravenous injection of LDE by intravenous for the effective use of this nanoemulsion as therapy target in primary tumors of breast.
 
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Publishing Date
2008-06-30
 
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