Evaluation of parathyroid hormone and zoledronic acid in promoting bone healing after stereotactic radiation therapy for local control of osteosarcoma in an orthotopic rat model
Date
2014
Authors
Curtis, Ryan C., author
VandeWoude, Sue, advisor
Donahue, Seth, advisor
Custis, Jamie, committee member
Ehrhart, Nicole, committee member
Ehrhart, EJ, committee member
Journal Title
Journal ISSN
Volume Title
Abstract
Clinical studies using definitive-intent stereotactic radiation therapy (SRT) for the local treatment of canine osteosarcoma (OSA) have achieved similar median survival times in patients as the current standard of care (amputation and adjuvant chemotherapy). Despite this, there remains an unacceptably high risk of pathologic fracture following radiation treatment. Zoledronic acid (ZA) and parathyroid hormone (PTH) are therapeutic candidates for decreasing this fracture risk post-irradiation. Due to differing mechanisms, we hypothesized that the combined treatment with ZA and PTH would significantly improve bone healing more than ZA or PTH treatment alone. Using an orthotopic model of canine osteosarcoma in athymic rats, we evaluated bone healing following clinically-relevant doses of radiation therapy (12Gy x 3 fractions, 36 Gy total). Groups included 36 Gy SRT only, 36 Gy SRT plus ZA , 36 Gy SRT plus ZA and PTH, 36 Gy SRT plus PTH, and 36 Gy SRT plus localized PTH treatment. Our study showed significant increases in bone volume and polar moments of inertia within the region of interest (distal femoral metaphysis) 8 weeks after radiation in the combined (ZA/PTH) treatment group as compared to radiation treatment alone. Histomorphometric analysis revealed evidence of active mineralization at study endpoint as well as successful tumor-cell kill across all treatment groups. This work provides further evidence for the expanding potential indications for ZA and PTH therapy, including post-irradiated bone disease due to canine osteosarcoma.