Ultrasound-stimulated microbubble radiation enhancement of tumors: Single-dose and fractionated treatment evaluation

PLoS One. 2020 Sep 25;15(9):e0239456. doi: 10.1371/journal.pone.0239456. eCollection 2020.

Abstract

The use of ultrasound-stimulated microbubble therapy has successfully been used to target tumor vasculature and enhance the effects of radiation therapy in tumor xenografts in mice. Here, we further investigate this treatment using larger, more clinically relevant tumor models. New Zealand white rabbits bearing prostate tumor (PC3) xenografts received a single treatment of either ultrasound-stimulated microbubbles (USMB), ionizing radiation (XRT; 8Gy), or a combination of both treatments (USMB+XRT). Treatment outcome was evaluated 24 hours after treatment using histopathology, immunolabeling, 3D Doppler ultrasound and photoacoustic imaging. A second cohort of rabbits received multiple treatments over a period of three weeks, where USMB treatments were delivered twice weekly with daily XRT treatments to deliver a fractionated 2Gy dose five days per week. A significant decrease in vascular function, observed through immunolabeling of vascular endothelial cells, was observed in tumors receiving the combined treatment (USMB+XRT) compared to control and single treatment groups. This was associated with an increase in cell death as observed through in situ end labeling (ISEL), a decrease in vascular index measured by Power Doppler imaging, and a decrease in oxygen saturation. In rabbits undergoing the long-term fractionated combined treatment, a significant growth delay was observed after 1 week and a significant reduction in tumor size was observed after 3 weeks with combined therapy. Results demonstrated an enhancement of radiation effect and superior anti-tumor effect of the combination of USMB+XRT compared to the single treatments alone. Tumor growth was maximally inhibited with fractionated radiotherapy combined with the ultrasound-stimulated microbubble-based therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cell Death / radiation effects
  • Cell Line, Tumor
  • Cell Proliferation / radiation effects
  • Combined Modality Therapy / methods
  • Endothelial Cells / radiation effects
  • Humans
  • Male
  • Mice
  • Microbubbles / therapeutic use*
  • PC-3 Cells
  • Prostatic Neoplasms / radiotherapy*
  • Rabbits
  • Ultrasonic Therapy / methods*
  • Ultrasonic Waves

Grants and funding

This work was supported by the Canadian Breast Cancer Foundation and a Terry Fox Foundation program Project Grant in Ultrasound and MRI for Cancer Therapy with funds from the Hecht Foundation. Dr. Gregory Czarnota was supported by the James and Mary Davie Chair in Cancer Imaging and Ablation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.