Invited ReviewPlasma in cancer treatment
Introduction
Although a relatively new field in plasma medicine, the use of cold atmospheric plasma (CAP) on tumour cells has attracted a great deal of attention. The results of several groups have fuelled the hope that CAP could be an interesting new therapy opportunity in the treatment of cancer. It has been shown in vitro, that CAP in low concentration was able to stop tumour cells growing, to induce cell death in higher concentrations and that this was more effective than some standard treatments including radiation and chemotherapy. Moreover, first results indicated that CAP seemed to be selective for cancer cells since it was more effective in tumour cells than in normal non-neoplastic cells.
There are some difficulties to review plasma in oncology, too. The different groups working in this field used different plasma devices with completely different plasma chemistries and cell lines derived from different tumour tissues. Furthermore, most results were obtained in cell culture. To this day there are only the very first in vivo studies. We will therefore summarize the data available in this new field of plasma medicine in a chronological order.
Section snippets
The early years
The first results of plasma treatment of mammalian cells were reported by the group of Eva Stoffels almost 10 years ago. Although not obtained in tumorigenic cells their results are important since they established the basic effects of cold plasma on mammalian cells. In addition, immortalized non-neoplastic cells share many aspects in their cellular biology and growth behaviour with tumour cell lines. Using a plasma needle device the Stoffels group showed that fibroblasts and vascular cells
The current developments in “plasma oncology”
The first in vivo anti-cancer treatment experiments were reported by Vandamme et al. [21], [22] using human U87 glioblastoma cells as heterotopic subcutaneous xenotransplants in nude mice. Glioblastoma is the most common and most aggressive human brain tumour. It is highly resistant against standard treatment including radiotherapy and chemotherapy. CAP treatment for 5 consecutive days showed a marked anti-tumour effect resulting from a significant reduction in tumour volume and a consequent
Where do we stand?
After a decade of “plasma oncology” a broad spectrum of different tumours cells has been treated, including carcinomas, skin cancer and brain tumours. In all different tumour types CAP was effective indicating that the effects of plasma seem to be uniform and are not restricted to a particular tumour type. This is remarkable since normal non-neoplastic cells seem to react in a more restrictive way, indicating that there are cell type-specific differences in the cellular reaction to CAP.
Prerequisites for further development
Plasma oncology is a growing scientific field with several important open questions. The answers will be the prerequisite for the further development to a serious medical treatment of cancer. A standardized measurement of the capacities of the different plasma devices and the resulting plasma chemistry would be helpful for a better comparability of the different approaches [42]. It is absolutely necessary to develop orthotopic approaches as experimental tools for the further investigations
Conclusion
"Plasma oncology", i.e., the use of cold atmospheric plasma (CAP) for the treatment of tumours is a novel field in plasma medicine. The results of several studies that are summarized within this review show that CAP is effective against tumour cells both in vitro and in vivo. Plasma treatment induces cell cycle arrest in low doses and apoptosis in medium doses. These effects seem to be mediated by reactive species, mainly reactive oxygen species (ROS). The current developments in this field
Conflict of interest statement
The authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence their work.
References (45)
- et al.
Induction of cell growth arrest by atmospheric non-thermal plasma in colorectal cancer cells
Journal of Biotechnology
(2010) - et al.
Cold atmospheric plasma for the ablative treatment of neuroblastoma
Journal of Pediatric Surgery
(2013) - et al.
Apoptosis of lung carcinoma cells induced by a flexible optical fiber-based cold microplasma
Biosensors and Bioelectronics
(2011) - et al.
Electric discharge plasmas influence attachment of cultured CHO K1 cells
Bioelectromagnetics
(2004) - et al.
Plasma treatment of mammalian vascular cells: a quantitative description
IEEE Transactions on Plasma Science
(2005) - et al.
Plasma needle for in vivo medical treatment: recent developments and perspectives
Plasma Sources Science and Technology
(2006) - et al.
Delayed effects of cold atmospheric plasma on vascular cells
Plasma Processes and Polymers
(2008) - et al.
Cell treatment and surface functionalization using a miniature atmospheric pressure glow discharge plasma torch
Journal of Physics D: Applied Physics
(2006) - et al.
The effects of micro-plasma on melanoma (G361) cancer cells
Journal of the Korean Physical Society
(2009) - et al.
Surface molecules on HaCaT keratinocytes after interaction with non-thermal atmospheric pressure plasma
Cell Biology International
(2012)
Living tissue under treatment of cold plasma atmospheric jet
Applied Physics Letters
Floating electrode dielectric barrier discharge plasma in air promoting apoptotic behavior in melanoma skin cancer cell lines
Plasma Chemistry and Plasma Processing
Ablation of liver cancer cells in vitro by a plasma needle
Applied Physics Letters
Induction of apoptosis in human breast cancer cells by a pulsed atmospheric pressure plasma jet
Applied Physics Letters
Micronucleus formation induced by dielectric barrier discharge plasma exposure in brain cancer cells
Applied Physics Letters
Dose-dependent killing of leukemia cells by low-temperature plasma
Journal of Physics D: Applied Physics
“Where, O death, is thy sting?” A brief review of apoptosis biology
Molecular Neurobiology
Cell permeabilization using a non-thermal plasma
New Journal of Physics
The effects of cold atmospheric plasma jets on B16 and COLO320 tumoral cells
Roumanian Archives of Microbiology and Immunology
Cold atmospheric plasma jet effects on V79-4 cells
Roumanian Archives of Microbiology and Immunology
Low-temperature plasmas for medicine?
IEEE Transactions on Plasma Science
Applied plasma medicine
Plasma Processes and Polymers
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