Abstract. The aim of this study was to investigate the effect of temozolomide (TZM) in combination with X-rays on proliferation and migration in human glioma spheroids. Multicellular spheroids were derived from GaMg and U87 cell lines. Spheroids were treated with various concentrations of TZM (5 μmol, 0.025 mmol, 0.05 mmol) and irradiation (RT). Proliferation and migration assays were performed. For GaMg spheroids, the proliferation inhibition was 30% (RT), 71%, 79%, 85% (for various TZM concentrations) and 78%, 83%, 90% following RT+TZM. For U87 spheroids, the inhibition of proliferation was 52% (RT), 62%, 78%, 88% (TZM), and 73%, 87%, 92% (RT+TZM). Inhibition of migration for GaMg was 30% (RT), 37%, 63%, 78% (TZM), and 56%, 75%, 84% (RT+TZM). For U87, migration inhibition was 29% (RT), 48%, 52%, 67% (TZM), and 62%, 67%, 73% (RT+TZM). Radiotherapy enhancement ratio (RER) of GaMg/U87 spheroid proliferation was 1.4/1.7 (5 μmol TZM), 1.3/1.8 (0.025 mmol TZM), and 1.4/1.4 (0.05 mmol TZM). RER for migration of GaMg/U87 was 2.2/1.9 (5 μmol TZM), 1.7/1.8 (0.025 mmol TZM), and 1.5/1.4 (0.05 mmol TZM). In terms of inhibition of proliferation and migration, irradiation can lead to an enhancement of the TZM effect in human glioma spheroids, which is less than additive.
IntroductionGliomas are the most common primary human brain tumours and prognosis is poor, in particular with high-grade tumours such as glioblastoma multiforme (GBM). Intensive surgery followed by radiotherapy with or without adjuvant chemotherapy is considered as standard therapy for primary brain tumours (1). Treatment of brain tumours with adjuvant chemotherapy, mainly 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), has only resulted in minor improvements (2-4). Phase I-II clinical studies with temozolomide (TMZ) have demonstrated that this drug crosses the blood-brain barrier and has activity against malignant glioma (5-8).TMZ in the treatment of primary and recurrent malignant brain tumours is still a topic of clinical trials due to the promising pre-clinical and clinical reports. Recently, Stupp et al found a clinically meaningful increase, by a factor of 2.5, in the survival rate at two years, from 10% with radiotherapy alone to 27% with radiotherapy plus TZM in a randomized phase III trial. The addition of temozolomide to irradiation was associated with improvements in median progression-free survival (6.9 vs. 5.0 month) and overall survival (14.6 vs. 21.1 month) (9).Since radiotherapy in combination with TMZ might be assumed as gold standard in the treatment of brain malignancies in future (10), it is of interest to investigate further what the pre-clinical effects are on various human glioma cell lines. In a study with the human glioma cell line U373 treated as monolayer cultures, an additive effect was reported for TMZ and X-rays (11). In glioma cells lines U251 and D384, combinations of TMZ and X-rays showed additional as well as supra-additional cytotoxic effects (12).We have chosen spheroid...