Beniamino Palmieri1, Farid Saleh2, Giorgia Benuzzi1, Alyaa Mousa2, Ali Shamseddine3, Khalid Al-Sebeih4
1Department of General Surgery and Surgical Specialty, University of Reggio Emilia, Surgical Clinics, Via del Pozzo, 71, 41100 Modena, Italy
2Department of Anatomy, Faculty of Medicine, Health Science Centre, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait
3Department of Oncology, Faculty of Medicine, American University of Beirut, P.O. Box: 11-0236, Lebanon
4Department of Surgery, Head and Neck Surgery, Faculty of Medicine, Health Science Centre, Kuwait University, Kuwait
DOI: 10.1186/1477-3163-7-5
AABSTRACT
Background and Aim: Silicone oil or gel has well-defined chemotactic properties on monocytes and lymphocytes in vivo . It results in fibrotic reaction when spread into the human tissues either incidentally or purposely and can slowly release any physically-enclosed lyophilized compounds due to its viscosity. Our aim is to investigate whether polydimethylsiloxane could be considered as an effective medium in the local treatment of cancer.
Materials and Methods: Our study was conducted between January 2004 and December 2006 on 15 patients with various types of cancer. The criteria for selection included patients with locally-advanced tumor that was rapidly growing and life threatening and those who had poor quality of life and general wellbeing. The patients were already discharged from the cancer centre before joining the study, after they had already received their chemoradiation protocol. Once a week for one month, different areas of the tumor were injected with 0.25 ml of polydimethylsiloxane medical grade (viscosity: 350 centistokes at 30°C), mixed with 300,000 units of lyophilized human IL-2. Tumor biopsies were taken before the study was started and one week after the last injection for the histopathological analysis of the percentage of severe inflammatory reaction using an image analysis system. CT scans of the tumor were taken before the injection cycle was started and one week after the last injection in order to determine the percentage change in the size of the tumor. The quality of life and general wellbeing of the patients was assessed at the beginning of the stud, and one week after the study was over by using the Karnofsky performance test.
Results: Our treatment was well tolerated by the patients. They had a significant improvement in their quality of life and general well being ( p = 0.0005). The prognosis of the patients before the beginning of the study ranged between 1 and 6 months, while their overall survival after treatment was between 2 and 12 months, with three patients still remaining alive. A significant decrease in the tumor size was observed at the end of the study in 12 patients ( p < 0.0001). Such a decrease was associated with a significant increase in the percentage of the tumor containing a severe immune reaction ( p < 0.0001). A significant correlation was found between the percentage reduction in tumor size and the percentage of tumor immune reaction (r 2 = 0.968; p < 0.0001).
Conclusion: Polydimethylsiloxane could be used as an effective cytokine medium in the local treatment of cancer. When injected inside the tumor, it is capable of creating and modulating an effective, slow and persistent antitumor immune response. Moreover, it is capable of improving the overall survival as well as the quality of life and general well being of the cancer patients.
Keywords: Cancer immunology, polydimethylsiloxane.