Congenital malignant gliosarcoma.
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The authors report 2 cases of frontal tumors in adult men with neuroradiological signs of malignant glial tumor. Histological study allowed to diagnose a mixed gliosarcomatosis tumor. Scannographical, histological and ultrastructural signs are specifically studied.
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Micro-proton-induced X-ray emission (Micro-PIXE) was applied to determine inter- and intracellular distribution of boron (10B) and gadolinium (157Gd), the capture atoms used to kill tumor cells in neutron capture therapy (NCT). Cultured 9L gliosarcoma cells on Mylar film were exposed to sodium borocaptate (BSH) and gadobenate dimeglumine (Gd-BOPTA). To analyze the inter- and intracellular distribution of 10B and 157Gd in 9L gliosarcoma cells, the cells were irradiated using a proton beam of 1.7 or 3 MeV energy collimated to 1 microm diameter and emission X-ray was detected. The distribution of 10B and 157Gd in 9L gliosarcoma cells was then examined. In this study, we could directly analyze the inter- and intracellular distribution of 10B and 157Gd elements in 9L gliosarcoma cells directly using Micro-PIXE. This is the first report on the distribution of 10B employing a method to detect gamma-rays resulting from the nuclear reaction of 10B using particle-induced gamma-ray emission (PIGE). These results show that the distribution of 157Gd elements was correctly measured using micro-PIXE. 157Gd should have the same tendency as 10B in cultured 9L gliosarcoma cells and agree with the distribution in 9L gliosarcoma cells. Further investigation is necessary for a higher spatial resolution and optimization of the measurement time or improvement of the sampling method. In the future, it will be possible to employ this method to analyze the intracellular microdistribution of the capture element and in the development of new drugs for NCT.
OBJECT: Glioblastoma multiforme (GBM) is a malignant tumor of the central nervous system that directly suppresses immunological defenses in vitro and in vivo. The authors used the peripheral delivery of continuously infused granulocyte-macrophage colony-stimulating factor (GM-CSF) in the presence of irradiated tumor antigens as a tumor-specific stimulant to dendritic cells to initiate an immune response to GBM in rats. METHODS: The 9L gliosarcoma tumors were established in the flanks of syngeneic Fischer 344 rats. Osmotic minipumps implanted in the animals' contralateral flanks continuously delivered recombinant GM-CSF (0, 0.1, 1, or 10 ng/day) for 28 days. Irradiated gliosarcoma cells were intermittently injected at the site of the GM-CSF infusion. Animals in the saline control group (0 ng/day GM-CSF) died on Day 59 with average tumor volumes greater than 30,000 mm3. This control group was significantly different from the GM-CSF-treated animals, which all survived with average tumor volumes that peaked on Day 23 and later regressed completely. Tumor growth as well as peak tumor volumes (5833+/-2284 mm3, 3294+/-1632 mm3, and 1979+/-1142 mm3 for 0.1, 1, and 10 ng/day GM-CSF, respectively) in the different treatment groups reflected a significant dose-response relationship with the GM-CSF concentrations. All animals treated with GM-CSF and irradiated cells were resistant to additional challenges of peripheral and intracerebral gliosarcoma, even when they were inoculated 8 months after initial immunotherapy. The colocalization of GM-CSF and inactivated tumor antigens was required to stimulate immunoprotection. To test the efficacy of a peripherally administered immunological therapy on intracerebral brain tumors the authors transplanted 10(6) gliosarcoma cells into the striatum of treated and control animals. Subcutaneous pumps that released GM-CSF (10 ng/day) and irradiated gliosarcoma cells were placed in the treated animals. The control animals all died within 31 days after intracerebral tumor implantation. In contrast, 40% of the animals receiving GM-CSF-irradiated cell vaccinations survived beyond 300 days. These long-term survivors showed no evidence of gliosarcoma at the injection site on evaluation by magnetic resonance imaging. CONCLUSIONS: These results suggest that the continuous localized delivery of subcutaneous GM-CSF in conjunction with inactivated tumor antigens can initiate a systemic response that leads to the regression of distant peripheral and intracerebral tumors. The success of this treatment illustrates the feasibility of tumor-specific peripheral immunological stimulation after tumor resection to prevent the recurrence of malignant brain tumors.
Boron neutron capture therapy (BNCT) is dependent on the selective accumulation of boron-10 in tumor cells relative to the contiguous normal cells. Ion microscopy was used to evaluate the microdistribution of boron-10 from p-boronophenylalanine (BPA) in the 9L rat gliosarcoma and the F98 rat glioma brain tumor models. Four routes of BPA administration were used: i.p. injection, intracarotid (i.c.) injection [with and without blood-brain barrier disruption (BBB-D)], and continuous timed i.v. infusions. i.p. injection of BPA in the 9L gliosarcoma resulted in a tumor-to-brain (T:Br) boron-10 concentration ratio of 3.7:1 when measured at the tumor-normal brain interface. In the F98 glioma, i.c injection of BPA resulted in a T:Br ratio of 2.9:1, and this increased to 5.4:1 when BBB-D was performed. The increased tumor boron uptake would potentially enhance the therapeutic ratio of BNCT by >25%. At present, ion microscopy is the only technique to provide a direct measurement of the T:Br boron-10 concentration ratio for tumor cells infiltrating normal brain. In the 9L gliosarcoma, this ratio was 2.9:1 after i.p. administration. In the F98 glioma, i.c injection resulted in a ratio of 2.2:1, and this increased to 3.0:1 after BBB-D. Ion microscopy revealed a consistent pattern of boron-10 microdistribution for both rat brain tumor models. The boron-10 concentration in the main tumor mass (MTM) was approximately twice that of the infiltrating tumor cells. One hour after a 2-h i.v. infusion of BPA in rats with the 9L gliosarcoma, tumor boron-10 concentrations were 2.7 times higher than that of infiltrating tumor cells [83 +/- 23 microg/g tissue versus 31 +/- 12 microg/g tissue (mean +/- SD)]. Continuous 3- and 6-h i.v. infusions of BPA in the 9L gliosarcoma resulted in similar high boron-10 concentrations in the MTM. The boron-10 concentration in infiltrating tumor cells was two times lower than the MTM after a 3-h infusion. After 6 h, the boron-10 concentration in infiltrating tumor cells had increased nearly 90% relative to the 2- and 3-h infusions. A 24-h i.v. infusion resulted in similar boron-10 levels between the MTM and the infiltrating tumor cells. Boron concentrations in the normal brain were similar for all four infusion times (approximately 20 microg/g tissue). These results are important for BNCT, because clinical protocols using a 2-h infusion have been performed with the assumption that infiltrating tumor cells contain equivalent amounts of boron-10 as the MTM. The results reported here suggest that this is not the case and that a 6-h or longer infusion of BPA may be necessary to raise boron-10 levels in infiltrating tumor cells to that in the MTM.
Twenty-five neonatal beagles were used for this study. Gliosarcoma was injected into the cerebral hemisphere of 7 neonatal beagles (Group I). These animals were then treated by boron neutron capture therapy. The response of the tumor to therapy was evaluated by serial CT scans and 3 times magnification of cerebral angiography. The animals were sacrificed at varying post-therapy periods for histological study. Fifteen neonatal beagles implanted gliosarcoma without therapy (Group II) and 3 normal controls without tumor (Group III) were subjected to the same follow-up studies. (Results) (1) Neonatal beagles with implanted tumor showed moderate degree of ventricular dilatation within a short period. The finding of communicating hydrocephalus was interpreted as initial growth of tumor. (2) Animals after therapy had variable cavitation in the hemisphere that had contained calcium deposit on CT. Moderate dilatation of the lateral ventricle was present without any significant midline shift and there was an area of porencephaly extending out from the right lateral ventricle on CT (Fig. 1, Case 2). Cerebral angiography demonstrated hydrocephalus with an avascular region in the right cerebral hemisphere, compatible with the previously described porencephalic cyst (Fig. 2, Case 2). (3) Three cases out of 7 showed neurological symptoms after tumor implantation (Cases 3, 5 and 6). Carotid angiography showed large temporal lobe tumor with some tumor stain and also some involvement of the right frontal lobe after therapy (Fig. 7, Case 3). In postmortem examination, there was tumor seen coating the right lateral ventricle as well as the left temporal horn. The right cerebral hemisphere was slightly smaller than the left. The left lateral ventricle was remarkably enlarged (Fig. 9). (4) Four out of 7 treated animals with injected gliosarcoma showed no evidence of tumor at postmortem examination. CT demonstrated moderate dilatation of the lateral ventricle without any significant midline shift, an area of porencephaly and definite decrease in size of the right cerebral hemisphere and calvarium (Fig. 4). (5) Fifteen neonatal beagles implanted gliosarcoma without therapy (Group II) developed symptomatic and died within two weeks. (6) Control animals showed no ventricular dilatation or other abnormalities. (7) Microscopic examinations showed no similarities between implanted gliosarcoma and human glioblastoma. (Conclusion) Serial CT scans and magnification cerebral angiography in this experimental model appear extremely helpful in following the effects of therapy and important tool for the evaluation of a tumor growth or regression.
PURPOSE: To investigate the ability of systemically delivered BCNU to enhance the activity of either systemically delivered irinotecan (CPT-11) or locally delivered camptothecin from a biodegradable polymer for treatment of an intracranial 9L gliosarcoma. METHODS: We used a single systemic dose of BCNU on treatment day 1 in combination with systemic doses of CPT-11 on treatment days 1-5 and 8-12 against an intracranial rat 9L gliosarcoma model implanted into female Fischer 344 rats. We also used the same systemic dose of BCNU given on treatment day 1, followed by a local dose of a 20% loaded camptothecin biodegradable polymer implanted on the same day. RESULTS: Two doses of CPT-11 (10 and 60 mg/kg) were delivered systemically against intracranial 9L. Neither dose showed an increase in survival compared to controls ( P>0.2 for 10 mg/kg and P=0.17 for 60 mg/kg). Systemic delivery of CPT-11 (10 mg/kg per day) in combination with systemic BCNU (15 mg/kg) did not show a significant effect on survival compared to systemic BCNU alone ( P>0.2), even at the maximally tolerated systemic dose of CPT-11 (60 mg/kg per day; P=0.06). The combination of systemic BCNU (15 mg/kg) and intracranial delivery of camptothecin (20% loaded polymer), however, significantly extended survival compared to systemic BCNU alone ( P<0.001) and compared to intracranial delivery of camptothecin alone ( P=0.01). CONCLUSIONS: In a 9L gliosarcoma model, systemic delivery of CPT-11 showed no benefit in survival when delivered alone or in combination with systemic BCNU, because CPT-11 is unable to cross the blood-brain barrier in cytotoxic levels. When cytotoxic levels of a topoisomerase I inhibitor are delivered directly to the brain tumor via a biodegradable polymer, however, the systemic delivery of the alkylating agent BCNU significantly enhances the antitumor effects of camptothecin in a 9L gliosarcoma model.
Higher cyclooxygenase-2 (COX-2) expression is clinically associated with more aggressive gliomas and is a strong predictor of poor survival. To determine whether oral administration of a COX-2-specific inhibitor can inhibit glial tumors, we analyzed the effect of celecoxib on the growth of 9L rat gliosarcoma cells that were orthotopically transplanted into rat brains. Oral administration of celecoxib beginning 1 day after implantation of 5 x 10(4) 9L rat gliosarcoma cells into rat brain reduced the incidence and size of tumors significantly. Immunohistochemical analysis of implanted gliosarcoma cells from rats treated with celecoxib showed lower levels of phospho-Akt, phospho-EGFR, Bcl-2, and Bcl-XL expression compared with untreated tumor cells. Gliosarcoma cells from treated rats had significantly more TUNEL- and caspase-3-positive cells and fewer PCNA-positive cells. These results demonstrate that selective COX-2 inhibitors may be useful as adjuvants and/or therapeutic agents to treat gliomas overexpressing COX-2.
INTRODUCTION: Local delivery of adriamycin (ADR) via biodegradable polymers has been shown to improve survival in rats challenged intracranially with 9L gliosarcoma. Likewise, local delivery of interleukin-2 (IL-2) has been shown to extend survival in experimental brain tumor models. In the current study, we hypothesized that local delivery of ADR and IL-2 might act synergistically against experimental intracranial glioma. METHODS: Polyanhydride polymers (PCPP-SA) containing 5% ADR by weight were prepared using the mix-melt method. IL-2 polymer microspheres (IL-2 MS) were produced via the complex coacervation of gelatin and chondroitin sulfate in the presence of IL-2. Sixty male Fisher 344 rats received an intracranial challenge with a lethal dose of 9L gliosarcoma cells. In addition, a group of rats were injected with either IL-2 MS or empty microspheres. Five days later they received ADR or blank polymer. There were a total of four treatment groups: (1) empty microspheres, blank polymer; (2) empty microspheres, ADR polymer; (3) IL-2 MS, blank polymer; and (4) IL-2 MS, ADR polymer. RESULTS: Compared to control animals treated with empty microspheres and blank polymer, animals receiving empty microspheres and ADR polymer (P < 0.0004), IL-2 MS and blank polymer (P < 0.0005), and IL-2 MS combined with ADR polymer (P < 0.0000002) all showed statistically significant improvement in survival. In addition, animals receiving the IL-2/ADR combination had significantly extended survival compared to either ADR or IL-2 alone (P < 0.000003 and P < 0.0004, respectively). CONCLUSIONS: Both ADR and IL-2, when delivered locally, are effective monotherapeutic agents against experimental intracranial gliosarcoma. The combination ADR and IL-2 therapy is more effective than either agent alone.
The September2003 COM. A 79-year-old woman with prior history of breast cancer and meningioma presented with headache, memory changes and sleep disturbance for four months. CT and MRI revealed a large cystic mass in the right frontal lobe with heterogeneity and an enhancing border. She had a craniotomy and resection of tumor. The tumor was histologically consistent with gliosarcoma. Gliosarcomas exhibit clinical features and genetic profiles similar to primary (de novo) glioblastoma. Gliosarcomas have the same as prognosis as glioblastoma multiforme.
OBJECTIVE: The feasibility of high resolution CT imaging for evaluating experimentally-induced brain tumors in rats was assessed. METHODS: The gliosarcoma cell line (9 L/lacZ) was inoculated in 34 male Fischer 344 rats and CT studies were performed prior to and at 4, 7, 9, 12 and 14 days post-tumor cell implantation. Brain imaging pre- and post-contrast was performed and correlated with autopsy findings. RESULTS: Tumors were identified by CT in 19 of the 34 animals after contrast administration and their presence was confirmed at autopsy. Tumors were present at autopsy and not identified by CT scanning in eight additional animals and in the remaining seven animals, the CT scan was normal and no tumors were present at autopsy. The sensitivity and specificity of CT scanning with contrast in detecting tumors in this rat model of gliosarcoma was 70 and 100%, respectively. CONCLUSION: The improved CT technology currently available can be used to identify and follow tumor burden in a rat model of gliosarcoma, and be a good tool to utilize in determining treatment outcomes experimentally, especially when MR imaging is not available.
OBJECTIVE: Growth patterns of astrocytic tumors can be modulated in vitro by gastrin. In this study, the influence of gastrin on the in vitro cell cycle kinetics and the in vivo growth features of three experimental malignant gliomas was investigated. METHODS: Gastrin-induced influence on overall growth was assayed in vitro by means of the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium colorimetric assay for human U373 and rat C6 gliomas and for rat 9L gliosarcoma. Although cell cycle analyses were performed by means of computer-assisted microscope analyses of Feulgen-stained nuclei, the gastrin-induced effects of the levels of expression of cyclins D3 and E, CDK2, CDK4, CDK5, CDK7, p15, p16, E2F1, and E2F2 were assayed by means of quantitative Western blot test. The presence of ribonucleic acids for the CCK(B) and CCK(C) gastrin receptors in the U373, C6, and 9L models was assayed by means of quantitative reverse transcriptase-polymerase chain reaction, and the presence or absence of ribonucleic acids for CCK(A) receptor was checked by means of conventional polymerase chain reaction. The influence of gastrin was also characterized in vivo in terms of the survival periods of conventional rats orthotopically grafted with the C6 and 9L models and nude rats with the U373 model. RESULTS: Gastrin significantly decreased the overall growth rate in the rat C6 and the human U373 high-grade astrocytic tumor models with either CCK(B) or CCK(C) gastrin receptor but not in the 9L rat gliosarcoma, which had no CCK(B) gastrin receptor (but had CCK(A) receptor) and only weak amounts of CCK(C) receptor. This effect seems to occur via a cytostatic effect; that is, an accumulation of tumor astrocytes occurs in the G(1) cell cycle phase. The cytostatic effect could relate to a gastrin-induced decrease in the amounts of the cyclin D3-CDK4 complex in both C6 and U373 glioma cells. In vivo, gastrin significantly increased the survival periods of C6 and U373 glioma-bearing rats, but not of 9L gliosarcoma-bearing rats. CONCLUSION: Gastrin is able to significantly modify the growth levels of a number of experimental gliomas.