Significance of Fractionated Administration of Thalidomide Combined With gamma-Ray Irradiation in Terms of Local Tumor Response and Lung Metastasis

Shin-ichiro Masunaga, Yu Sanada, Takahiro Moriwaki, Keizo Tano, Yoshinori Sakurai, Hiroki Tanaka, Minoru Suzuki, Natsuko Kondo, Masaru Narabayashi, Tsubasa Watanabe, Yosuke Nakagawa, Akira Maruhashi, Koji Ono


Background: The aim of this study was to evaluate the significance of fractionated administration of thalidomide combined with γ-ray irradiation in terms of local tumor response and lung metastatic potential, referring to the response of intratumor quiescent (Q) cells.

Methods: B16-BL6 melanoma tumor-bearing C57BL/6 mice were continuously given 5-bromo-2'-deoxyuridine (BrdU) to label all proliferating (P) cells. The tumor-bearing mice then received γ-ray irradiation after thalidomide treatment through a single or two consecutive daily intraperitoneal administrations up to a total dose of 400 mg/kg in combination with an acute hypoxia-releasing agent (nicotinamide) or mild temperature hyperthermia (MTH). Immediately after the irradiation, cells from some tumors were isolated and incubated with a cytokinesis blocker. The responses of the Q and total (= P + Q) cell populations were assessed based on the frequency of micronuclei using immunofluorescence staining for BrdU. In other tumor-bearing mice, 17 days after irradiation, macroscopic lung metastases were enumerated.

Results: Thalidomide raised the sensitivity of the total cell population more remarkably than Q cells in both single and daily administrations. Daily administration of thalidomide elevated the sensitivity of both the total and Q cell populations, but especially the total cell population, compared with single administration. Daily administration, especially combined with MTH, decreased the number of lung metastases.

Conclusion: Daily fractionated administration of thalidomide in combination with gamma-ray irradiation was thought to be more promising than single administration because of its potential to enhance local tumor response and repress lung metastatic potential.

World J Oncol. 2014;5(4):155-165


Thalidomide; Vascular normalization; Nicotinamide; Mild temperature hyperthermia; Quiescent cell; Acute hypoxia; Chronic hypoxia

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