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Cryosurgery: a putative approach to molecular-based optimization.

Author(s) : BAUST J. G., GAGE A. A., CLARKE D., et al.

Type of article: Article

Summary

Cryosurgery must be performed in a manner that produces a predictable response in an appropriate volume of tissue. In present-day clinical practice, this is not always achieved. Concerns with cryosurgical techniques in cancer therapy focus in part on the incidence of recurrent disease in the treated site, which is commonly about 20-40% in metastatic liver tumours, and prostate cancers. Whether the cause of this failure is disease-based or technique related, cryosurgery for cancer commonly needs the support of adjunctive therapy in the form of anti-cancer drugs or radiotherapy to increase the rate of cell death in the peripheral zone of the therapeutic lesion where cell survival is in balance for several days post-treatment. Recent evidence has identified a third mechanism of cell death associated with cryosurgery: apoptosis or gene regulated cell death. Apoptosis is additive with the direct ice-related cell damage that occurs during the operative freeze-thaw intervals and coagulative necrosis that occurs over days post-treatment. The authors use a combination of literature review and new data to examine the combined roles of these distinct modes of cell death in a prostate and colorectal cancer. Data suggest that sub-freezing temperatures, when sequentially applied with low dose chemotherapy, may provide improved cancer cell death in the freeze zone periphery. Since most common chemotherapeutic agents initiate apoptosis in cancer cells, the observation that sub-freezing exposures yields a similar effect provides a possible route toward molecular-based procedural optimization to improve the therapeutic outcome.

Details

  • Original title: Cryosurgery: a putative approach to molecular-based optimization.
  • Record ID : 2005-0448
  • Languages: English
  • Source: Cryobiology - vol. 48 - n. 2
  • Publication date: 2004/04

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