In Vitro and In Vivo Effects of Antiblastic Loaded Polymethyl Methacrylate (Pmma) for the Management of Bone Metastasis: a Literature Review

Giulio M Sebastiano B,Domenico F Michele Attilio R

doi:10.4172/2329-6771.1000146

Abstract

In the last decades, survivorship of metastatic patients increased so much that orthopaedic surgeons have to perform a long lasting local treatment of bone secondary lesions to improve quality of life. The treatment has to be personalized for each patient according to tumour prognosis mainly due to histology or solitary/multiple metastases, metastatic localization, patient general conditions, previous normal or pathological ambulation. In the secondary lower limb lesions, when general conditions and prognosis are good, surgeons have to be aggressive, performing resections and implanting prostheses to allow a quick rehabilitation program. Otherwise, they can perform a more conservative surgery by curettage and local adjuvants in metastatic lower and upper limb lesions, with prognosis and general conditions are poor. Local treatment of bone metastases with adjuvants has been widely described in literature. The purpose of this review is to consider studies on antiblastic loaded acrylic cement as a treatment option for selected tumors.

Highlights

The metastatic patient survivorship depends on different prognostic factor as histotypes of tumour and sites of metastases, as Capanna et al said in 2001 [1]; Capanna developed a predictive scoring table considering different primitive tumour and prognosis (Table 1)
In 1992 Greco et al [3] tried to study in vitro cytotoxic effect of Polymethylmethacrylate (PMMA) -antiblastic drug compounds in cancer cell lines to explore a new method for local chemotherapy of bone metastasis
On July 2003 Rosa et al [4] made studies with ultrastructural and in vitro analyses of “Cylinders of manufactured acrylic cement containing three different antiblastic drugs, methotrexate, cisplatin and doxorubicin” to evaluate “the biological effect of the mixtures and surface analysis of the acrylic cement-cisplatin cylinders using energy-dispersive x-ray analysis (EDAX)” on “MCF-7 human breast cancer cells”. They prepared cylinders mixing under vacuum “powder (40 g) and a liquid monomer (20ml)” added with “50 mg of cloridrate doxorubicin powder” or “50 mg of cloridrate doxorubicin powder” or “50 mg of cisplatin powder”

Summary

Introduction

The metastatic patient survivorship depends on different prognostic factor as histotypes of tumour and sites of metastases, as Capanna et al said in 2001 [1]; Capanna developed a predictive scoring table considering different primitive tumour and prognosis (Table 1). He classified the patients in 4 groups (Table 2) and divided tumours in responsive and non responsive to adjuvant treatment (Table 3). Bone metastasis is a local expression of a systemic disease. Can a local treatment with antiblastic be effective in bone metastases management? Can a local treatment with antiblastic be effective in bone metastases management? Authors tried to explore literature to understand current situation

Discussion

Sources of metastasis Unknown Melanoma Lung Pancreas

Findings

Lung Uterus Pancreas