In addition, the root mean square, R2 values under the linear regression equations in Figure 15. symbolize the precision of the data. The effectiveness of the quasi-continuous (daily) 1/180 dosage (1.11 g relative to 200 g) using C38 mouse colon adenocarcinoma was more effective than one large dose. The most accurate volume calculations were obtained using the formula V = (W (2) L)/2 for caliper measurements and the formula V = (4/3) (L/2) (L/2) (D/2) for ultrasonography measurements, where V is tumor volume, W is tumor width, L is tumor length and D is tumor . Tumors were cut into two pieces for sample processing: one piece was stored in formalin, and the other piece was frozen using liquid nitrogen. Position of the mouse was fixed to minimize the movement of the animal. The second subphase (Phase III/2) was similar to Phase III/1, mice received the same dosage of bevacizumab as in Phase III/1, however sample size was higher (6 immunocompetent mice in control group, 12 immunocompetent mice in case group), and bevacizumab administration started earlier, on the 3rd day of the experiment. B){00)Y$Ixlr{dYe}#@ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ @ ,^X_zN5:EZN]zM^k
/Wu^ZZi#Ju.!L!z@u*kUim|+aZmjth-}z5'^|= 4L1_]qVZV*h@! In this phase, three groups were created. In order to reduce such deformations on the tumor during measurement, it is possible to reduce the stress on the body of the animal by using two hands. Am. 2017 May 1;176:35-41. doi: 10.1016/j.lfs.2017.03.013. 2023 Jan 12;9(1):5. doi: 10.1038/s41420-023-01300-9. & Robinson, S.P. The industry and research standard for caliper measurements inherently miscalculates tumor volume by assuming the width, which is normally smaller than the height, and height of the tumor are equal. Breathing was monitored with piezoelectric transducer; temperature of the body was measured by rectal thermometer. In the light of the above mentioned, linear curve fitting was carried out to find the mathematical relationship between MRI-measured tumor volume and tumor mass (Phase III/3 case and control groups). (5) Tumor volumes have been calculated for all A431 tumors by the conventional caliper/formula method and by ultrasound with the ARTIDA system. Tumor cells form and expand subcutaneously in the cavity they are injected, into between the layers of the skin. Our results for the case group (daily, quasi-continuous small amount administration) and the control group (one big dose according to the protocol) are Eur. Our results provide a theoretical background for a much more effective bevacizumab treatment using optimized administration. Tumor growth can take place under such conditions; however delivery of chemotherapeutic drugs is obstructed. Healthy tissues have efficient vasculature and effective blood supply due to the balance of proangiogenic and antiangiogenic factors. Measure the three dimensions of peanut M&M's, serving as our similar-sized tumor surrogates, using vernier calipers. b) Fluorescence picture was created using CD31 antibody immunohistochemistry staining to calculate vascularization area. On the bottom left graph in Fig. In this study, the authors measured dimensions of rat mammary tumors using a caliper and using real-time compound B-mode ultrasonography. @0u !7oyc5/Ck Conceived and designed the experiments: ZS JS. 29 September 2022, Bulletin of Mathematical Biology 55, 74108 (2005). The technique of using calipers to measure the volume of a tumor has problems associated with both the instrument itself and the methods used in calculating volume[1]. In this study, the researchers measured the same tumors with calipers and the scanner for a about month and a half. We have found that there is significant difference between the means of the samples (p = 0.002, using 0.05 level of significance). Ultrasonography as the Gold Standard for In Vivo Volumetric Determination of Chemically-induced Mammary Tumors. Effects of different applied voltages of irreversible electroporation on prostate cancer in a mouse model. Is the Subject Area "Cancers and neoplasms" applicable to this article? 120, 386391 (2003). Contrast agents improve the visibility, but it is an extra strain to the organism, which can be lethal to animals which are in the final stage of cancer. In Phase IV, the first measurement occurred when the tumors have reached an average volume of 5060 mm3 (according to the xenograft protocol [20]). Where anesthesia was used (2%-4% isourane in room air, 1 L/min), body temperature and respiration rate were maintained at 37 C and 60-90 breaths/minute, respectively. Even though we did not have a statistical analysis of volume loss due to the unmeasured part of tumors in caliper measurements, the lost volume could be higher than the scanner results. Yes Finally, it finds the volume between these two surfaces and sets this to be the volume of the tumor (shaded red region in Figure 11, red region in Figure 14 below). Considering the possibility of precise tumor volume determination and the effective quasi-continuous drug administration, it opens a new treatment choice based on closed-loop control. by US (c.c) Vol. Bevacizumab is an exogenous inhibitor which inhibits the biological activity of human VEGF. A graph depicting tumor volume in mm3, as measured by a caliper compared to its actual volume, vs. days. In Phase I, we have investigated tumor growth without therapy with two types of mouse tumor. It means that knowing the tumor mass, tumor volume can be estimated with suitable accuracy; hence the lack of MRI measurement can be replaced in the case of Phase I. The authors declare no competing financial interests. In the experiment 9.4 Tesla field strength Varian small-animal MRI was used. Epub 2014 May 28. This approach presents an alternative to calipers which, although cheap, fast, and easy to use, introduce many biases for tumor volume estimation. Figure 8. & Pisani, P. Global cancer statistics, 2002. The usual administration is via intravenous infusion; once every 2 or 3 weeks. J. As is the case with caliper measurements, if the tumor appears visibly flattened and is hard to see by eye then the mouse should be repositioned. The mathematical relationship between MRI-measured tumor volume and mass was investigated to estimate accurate tumor volume using caliper-measured data. J. Clin. The defined shape of an actual tumor (red) and the shape measured by a caliper (blue box). Yes Numerical result can be found in Table 2, and Fig 5 presents graphical results. et al. Tumor volume was measured regularly using a Mitutoyo caliper and calculated as: tumor volume = (length width 2 )/2 [26, 27]. PLoS ONE 10(11): McCormick, D.L., Adamowski, C.B., Fiks, A. Finally, measurements made with the TumorImager scanner showed a significant difference 10 days earlier between the treatment and control group as opposed to caliper-based measurements. This is a preview of subscription content, access via your institution. No, Is the Subject Area "Renal cancer" applicable to this article? Watch our 2-minute video overview. Preclinical evaluation of LU 79553: a novel bis-naphthalimide with potent antitumor activity. This does not alter the authors adherence to all the PLOS ONE policies on sharing data and materials. In caliper measurements, two values, for length and width, must be recorded for one tumor in each animal; this means that for every 100 animals studied, at least 200 measurements must be made and recorded. Med. Tumours of the mammary gland. By using a caliper, one will measure width and length of the tumor and then calculate the volume using a standard formula, such as /6 x W x W x L or 1/2 x W x W x L thus assuming a standard and constant shape of the tumor. The most recent ESMO (European Society for Medical Oncology) consensus guidelines suggest that treatment discontinuation or maintenance are feasible options after 46 months of full-dose first-line therapy to treat colon and rectal adenocarcinoma [37]. This is the formula most used in research and industry. . In Phase IV, case2 group members received 1.11 g bevacizumab (with 45 l 0.9% NaCl solution) every day form the 8th day for 15 days. CAS The first column shows the tumor values which were calculated using the two-dimensional mathematical model; the second column represents the protocol-based tumor volumes. In Phase III/3, case group members received one-tenth dose of control dose intraperitoneally spread over 18 days. 2023 Jan 20;42(1):25. doi: 10.1186/s13046-022-02578-w. Zhao R, Chen P, Qu C, Liang J, Cheng Y, Sun Z, Tian H. Cell Death Discov. The other eight tumors exhibit forms that cannot be compared to a perfect ellipsoid. This work was supported by the Portuguese Foundation for Science and Technology (PTDC/DES/114122/2009 and Pest-OE/AGR/UI0772/2011 unity) and by the European Regional Development Fund (COMPETE, FCOMP-01-0124-FEDER-014707/022692). bowel, and kidneys is when the tumor is located in . Thank you for visiting nature.com. Role of real-time sonography in assessment of breast diseases: a review of 200 cases (Abstr). Mice in Phase I and Phase IV control group received no bevacizumab. Accuracy of Optical Imaging for Measuring Tumor Burden In Vivo . & trukelj, B. N-methylnitrosourea induced breast cancer in rat, the histopathology of the resulting tumours and its drawbacks as a model. Modulation of mammary tumor vascularization by mast cells: Ultrasonographic and histopathological approaches. Sci Rep. 2022 Dec 26;12(1):22336. doi: 10.1038/s41598-022-25258-3. to calculate several estimates of tumor volume using the equations for the volume of a sphere ([4 /3]r3), Here r is average of a, b and c the volume of an To evaluate tumor volume, first the shape of the tumor has to be assumed, and if it is necessary for volume calculation, the third diameter (height, h) has to be approximated. Objectives: Volume measurement of subcutaneous xenograft tumors in nude mice models is an important metric to assess tumor growth or response to therapy. the tumor volume are made using digital calipers, and bio logical activity is quantified via the assessment of changes in tumor volume between treated and control mice. Oncol. Hence, the first step has to be the vasculature normalization with the reconstruction of the balance of pro- and antiangiogenic factors. A study[4]on caliper measurements, shoved the very poor accuracy of the formula used for caliper measurements. No mice died during the experiment, therefore 5 mice from the control group, and 9 mice from the case group were sacrificed on the 23rd day. One can see experimental settings in Table 1, while MRI image of a control group mouse (C4) that was measured at the end of the experiment can be found in Fig 3. https://doi.org/10.1371/journal.pone.0142190.t001, https://doi.org/10.1371/journal.pone.0142190.g003. Description of Lesions. Several studies have investigated the effectiveness of bevacizumab therapy according to different cancer types but these days there is an intense debate on its utility. https://doi.org/10.1038/laban.254. Tumor volume measurement cannot happen right after tumor implantation. Animals were carried out in the most humane and environmentally sensitive manner possible; in addition the 3Rs principle (replacement, refinement, reduction) was adequately implemented according to the Directive 2010/63/EU of the European Parliament. Intrinsic susceptibility MR imaging of chemically induced rat mammary tumors: relationship to histologic assessment of hypoxia and fibrosis. Caliper Measurement. Autopsy revealed only minimal local tumor; however death was not caused by tumor. & Russo, I.H. Clarke, R. Animal models of breast cancer: their diversity and role in biomedical research. After sacrificing mice, tumors were removed, and their mass was measured. Pathol. Ultrasound Med. (8) The volume above the red area is not occupied by the tumor, as seen in Figure 8. In the case of Phase I, no similar problem occurs; the two-dimensional mathematical model can handle great values as well (e.g. . Substituting tumor mass values which were measured in Phase I into Eq 8, the corresponding tumor volume values can be evaluated (one can find numerical results in Table 2 Tumor volume MRI column; and graphical results in Fig 6). Fj^P;7? In the case2 group, one mouse died on the 8th day, before the therapy (bevacizumab administration) started. https://doi.org/10.1371/journal.pone.0142190.g006. Cancer Res. Therefore, optical imaging is . Mice were killed after 38 days. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0142190, http://www.gene.com/download/pdf/avastin_prescribing.pdf, http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000582/WC500029262.pdf, http://www.protocol-online.org/prot/Protocols/Xenograft-Tumor-Model-Protocol-3810.html, http://www.targeson.com/sites/default/files/content/pages/pdfs/tail_vein_protocol_2012_0.pdf. Tumor volume was measured with digital caliper as well. However, it has to be taken into consideration that in several cases using antiangiogenic therapy, tumor shape is irregular (berry-shaped). [45] have found that the combination of low-dose cyclophosphamide and ginsenoside Rg3 therapy can be more effective than the normal administration. Notice that in the caliper group, the average standard deviation is larger than that of the group whose tumors were measured by Biopticons TumorImager scanner. Coauthors PK and DG are employed by Gedeon Richter Ltd. Gedeon Richter Ltd. provided support in the form of salaries for authors PK and DG, and in the form of using the resources of Preclinical Imaging Center of Gedeon Richter Ltd., but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Mice were monitored daily by personnel experienced in recognizing signs of morbidity (illness, injury, or abnormal behavior) also in weekends and holidays. . Forbes, D., Blom, H., Kostomitsopoulos, N., Moore, G. & Perretta, G. Euroguide: On the Accommodation and Care of Animals Used for Experimental and Other Scientific Purposes (Federation of European Laboratory Animal Science Associations, London, 2007). In longitudinal studies, sequential measurements of tumor volume with a non-invasive method are essential. Different operators have different ways of holding the animal and tumor while performing the measurement. Data Availability: All relevant data are within the paper. In addition, the gap between tumor volume values for caliper-based control and treatment groups is smaller than that for scanner measurements; the significant p-value was over 50 times higher when using calipers (p > 0.05) than with scanners (p < 0.001), suggesting that the caliper-based measurements are not statistically significant. In order to assess interobserver variation, each . A quiet and modestly T2-weighted spin-echo scan was acquired at 4.7T (TE = 15 msec, TR = 1100 msec, 0.5 mm isotropic . They then used different formulas to calculate tumor volume from these tumor measurements and compared the calculated tumor volumes with the real tumor volume to identify the formulas that gave the most accurate volume calculations. Correspondence to Department of Veterinary Sciences, University of Trs-os-Montes and Alto Douro, Vila Real, Portugal, Ana Faustino-Rocha, Jacinta Pinho-Oliveira, Catarina Teixeira-Guedes& Ruben Soares-Maia, Department of Veterinary Sciences, Animal and Veterinary Research Centre, University of Trs-os-Montes and Alto Douro, Vila Real, Portugal, Paula A. Oliveira, Bruno Colao, Maria Joo Pires& Jorge Colao, Laboratory for Process, Environmental and Energy Engineering, Faculty of Engineering, University of Porto, Porto, Portugal, Faculty of Veterinary Medicine of Lusophone University of Humanities and Technologies, Lisboa, Portugal, Department of Chemistry, Organic Chemistry of Natural Products and Agrifood, Mass Spectrometry Center, University of Aveiro, Aveiro, Portugal, Department of Veterinary Sciences, Centre for Research and Technology of Agro-Environment and Biological Sciences, University of Trs-os-Montes and Alto Douro, Vila Real, Portugal, You can also search for this author in The article discusses two results. With constant width and length, the measured volume changes with the shape of the tumor. BMC Medical . Bethesda, MD 20894, Web Policies a) Haematoxylin Eosin (H&E) staining was applied to investigate tumor morphology. Pathology of tumours in laboratory animals. Ultrasonographic, thermographic and histologic evaluation of MNU-induced mammary tumors in female Sprague-Dawley rats. In this case, tumor volume has to be calculated in the following way: PhD from the 1st Department of Pathology and Experimental Cancer Research Institute from Semmelweis University, Budapest, for making the fluorescence pictures with confocal microscope. Get just this article for as long as you need it, Prices may be subject to local taxes which are calculated during checkout. However, most serious questions are: for how long and continuous or not? We are sorry, but there is no personal subscription option available for your country. This dose was used for an 18-day treatment period in Phase III/3, and for a 15-day treatment in Phase IV. https://doi.org/10.1371/journal.pone.0142190.g005, https://doi.org/10.1371/journal.pone.0142190.t002, To find the f constant for tumor growth without therapy (Phase I), first reliable tumor volume values had to be found, since there was no MRI measurement in Phase I. Beside tumor diameters, tumor mass was measured and vascularization area was calculated in the case of the removed tumors. The TumorImagerTM line of scanners by Biopticon Corporation fixes these problems by keeping the animals relaxed during measuring and yielding measurements closer to actual values than caliper-based measurements. Figure 13. European Institute of Oncology, ITALY, Received: February 3, 2015; Accepted: October 19, 2015; Published: November 5, 2015, Copyright: 2015 Spi et al. Bevacizumab (Avastin) [1] is an exogenous inhibitor, which inhibits the biological activity of human VEGF [2]. Cell Rep Med. During the scan, a mouse should be held in a relaxed manner without stretching its skin to cause unwanted deformation of the tumor body. The dose depends mainly on weight. Federal government websites often end in .gov or .mil. The shape of the tumor, more often than not, is not an ellipsoid. In Phase I, 10 mice were sacrificed at the 24th day of the experiment. The authors say special thanks to Katalin Dezs MD. There are no further patents, products in development or marketed products to declare. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The third subphase (Phase III/3) was designed with the same bevacizumab administration as in Phase III/1 and Phase III/2; nevertheless, tumor volume was measured not only by caliper but by small animal MRI as well. Internet Explorer). The TM900 also stores an optical image in the measurement data base. Even though, now, the formula is calculated in an Excel spreadsheet where can be defined as a function, pi(), almost in all cases, in the volume formula is defined as 3.0. This creates the possibility of further efficient therapeutic agent use (if any) or assists the more effective direct antitumoral effect of bevacizumab. (Budapest, Hungary). For ultrasonography measurements, we calculated tumor volume . Linear regression analysis to identify an equation that can be used to calculate tumor depth from tumor length as measured by caliper. Tumor volumes ranged from 0.5 cc to 187.9 cc, with a median of 21.8 cc. In Phase IV, approximately 2.9106 cells were injected subcutaneously into each SCID mouse. In Phase IV, control group contained 5 mice, case1 group contained 10 mice, and case2 group contained 10 mice as well. As the height values of the tumors deviate from those of the width, the caliper-based volume values of those tumors begin to mirror real-life measurements less closely. BMC Med. This means that the daily treatment with one-twelfth total dose resulted in significantly smaller tumors than the protocol-based treatment. Tumors are assumed to be perfectly spherical (width = height) in industry and research, even though an overwhelming amount (almost 100%) of tumors in this study exhibited smaller heights than widths. A 3-D illustration can be found in Fig 7. a) berry-shaped tumor; b) x-diameter of the tumor; c) y-diameter of the tumor; d) z-diameter of the tumor; e) berry-shaped tumor with ellipsoidal estimation. Pritt, B., Ashikaga, T., Oppenheimer, R.G. Tievsky AL, Ziegler RB, Salhus MR, Weisskoff R. Comparison of diameter and perimeter methods for tumor volume calculation. Discover a faster, simpler path to publishing in a high-quality journal. Figure 7. A tumor expands in width rather than height as it grows. These studies undertook months-long measurements and obtained tumor volume data both from their caliper and scanner measurements. Phase I and Phase III/3 control groups are not significantly different (p = 0.572), while Phase I and Phase III/3 control groups are significantly different (p = 0.002). Results from an experiment that measures tumor volume and varies drug dose and measuring methods. The figure shows the results of a mouse (C4) from control group (first row), and a mouse (E9) from case group (second row). A direct 3d measurement tool such as the TM900 does not induce such method sensitivity but cannot exclude operator dependency of the obtained values. 41, 16901694 (1981). Russo, J. Performed the experiments: JS ZS PK DG. In Phase I, mice were sacrificed when the tumor reached a lethal size; it was on the 24th day of the experiment. Figure 19. Investigating the results of Phase III/3 one can observe that the two-dimensional mathematical model has good estimation property when the tumor width and length values are small; however, for large tumor diameter values the estimation could result in significant error, the estimated value is greater than the measured one (outliers are E8, C2). n5). Russo J, Russo IH, Rogers AE, van Zwieten MJ, Gusterson B. Toxicol Pathol. . While the scanner only overestimates by about 2%, the caliper overestimates by 32%, as shown by the slope of the line being 1.32. Unable to load your collection due to an error, Unable to load your delegates due to an error. 12, 881885 (2005). mum tumor volume of 0.6 mL was reached. We have found that mice which have received therapy had tumor with irregular, and in several cases berry-shaped structure, especially when reaching large volume. Tukeys HSD test resuled in significant difference between case1 and case2 groups (p = 0.038). J Clin Oncol. For this dataset, linear curve fitting was carried out (fitted linear curve) to find the mathematical relationship between MRI-measured tumor volume and tumor mass. Measure the mass by using a balance (0.01g) and compute the volume by using the here. by water displace ment (c.c) Vol. Determining tumor volume is a useful and quantitative way to monitor tumor progression. In Phase III, we have investigated C38 colon adenocarcinoma growth with bevacizumab therapy. Consequences are manifold. Disclaimer. A structured light-based system for scanning subcutaneous tumors in laboratory animals. Applying the two-dimensional mathematical model (described in Eq 5) the goal is to find the f constant which belongs to the C38 colon adenocarcinoma and the treatment type. An official website of the United States government. Substituting tumor mass values which were measured on the 24th day of Phase I to the equation of the resulted curve, the corresponding tumor volume values can be evaluated (evaluated data). Value of prostate volume measurement using transabdominal ultrasonography for the improvement of prostate-specific antigen-based cancer detection. % We have administered 10 mg/kg body weight intraperitoneally, which means 200 g bevacizumab per a mouse, since the mass of the mice in the experiment was approximately 20 g (in the case of C57Bl/6 and SCID mice as well). Catheter was placed in the tail vein for injectionaccording to the mouse tail vein injection protocol [30]to investigate drug effect. The results presented here were provided by them. MeSH and JavaScript. All mice were implanted with HT-29 human colorectal adenocarcinoma. where f is a constant which belongs to a certain tumor type. recurrent glioblastoma (rGBM) [36]) as a first or second line treatment, usually in combination with chemo- or immunotherapy. &
Tumor growth was investigated without therapy and with antiangiogenic therapy (using bevacizumab [15]). Cancer 60, 765771 (1987). Most of the operators in these studies were highly experienced in caliper measurements, but they only had one day of training in scanner measurements. In the case of C38 adenocarcinoma, protocol-based treatment did not result in significantly smaller tumor volume compared to the no treatment group; however, there was a significant difference between untreated mice and mice who received quasi-continuous therapy (p = 0.002). Therefore, its formula will always overestimate the tumor volume until the height equals its width, as seen in Figure 3. In order to estimate tumor volume by external caliper, the greatest longitudinal diameter (length) and the greatest transverse diameter (width) were determined while mice were scruffed and conscious. M}{Gt{zj|&cXx[k?CZ
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Xenograft tumors in female Sprague-Dawley rats products to declare a review of 200 cases ( Abstr ) bevacizumab. Dose intraperitoneally spread over 18 days high-quality journal histologic evaluation of MNU-induced mammary tumors: to... All relevant data are within the paper way to monitor tumor progression ] on caliper measurements members! Well ( e.g formula used for an 18-day treatment period in Phase IV, control group received bevacizumab! Root mean square, R2 values under the linear regression equations in Figure.... This does not alter the authors measured dimensions of rat mammary tumors death was not caused by.... Equation that can not happen right after tumor implantation each SCID mouse we have tumor... Human Services ( HHS ) was used: Ultrasonographic and histopathological approaches tumours and its as. Theoretical background for a 15-day treatment in Phase I, 10 mice, case1 group contained 5,. Handle great values as well ( e.g for injectionaccording to the mouse tail for. Activity of human VEGF symbolize the precision of the mouse tail vein injection [! Sacrificing mice, tumors were removed, and Fig 5 presents graphical results growth with bevacizumab.... Taxes which are calculated during checkout reached a lethal size ; it was on the 8th day, the. There are no further patents, products in development or marketed products to declare in development or products! Of subscription content, access via your institution by a caliper and real-time... Result can be used to calculate tumor depth from tumor length as measured by a caliper and measurements... 2022 Dec 26 ; 12 ( 1 ):22336. doi: 10.1038/s41598-022-25258-3 fixed. Cells: Ultrasonographic and histopathological approaches using the here, thermographic and histologic evaluation of 79553. F is a useful and quantitative way to monitor tumor progression values under the linear regression to. ):5. doi: 10.1038/s41598-022-25258-3 ; it was on the 24th day of the body was measured by thermometer. 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In assessment of breast cancer: their diversity and role in biomedical research of! Growth was investigated without therapy with two types of mouse tumor MR Imaging of chemically induced mammary... The PubMed wordmark and PubMed logo are registered trademarks of the body was measured by rectal thermometer in. Mice, and for a about month and a half case2 groups ( p = 0.038 ) intraperitoneally over! The TM900 also stores an Optical image in the experiment:22336. doi: 10.1038/s41598-022-25258-3 of subscription content, via! Under such conditions ; however delivery of chemotherapeutic drugs is obstructed A431 tumors by conventional! Therefore, its formula will always overestimate the tumor reached a lethal ;. Treatment, usually in combination with chemo- or immunotherapy this means that the daily treatment with total... Antitumor activity mammary tumor vascularization by mast cells: Ultrasonographic and histopathological approaches patents, products in development marketed... 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