Combination Therapy with Low Copper Diet, Penicillamine and Gamma Knife Radiosurgery Reduces VEGF and IL-8 In Patients with Recurrent Glioblastoma
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Alireza Feli, Shima Jazayeri, Mohammad Ali Bitaraf, Masoud Solaymani Dodaran, Karim Parastouei, Mohammad Javad Hosseinzadeh-Attar
2017 Volume 18, Issue 7, p1999-2003
Abstract
Purpose: Vascular Endothelial Growth Factor (VEGF) and interleukin-8 (IL-8) appear important in tumor growth. In
this study, we have investigated the effect of copper reduction along with gamma knife radiosurgery on IL-8 and VEGF
in patients with recurrent glioblastoma multiforme (GBM). Materials and Methods: In a 3-month randomized clinical
trial, patients with recurrent GBM were allocated randomly between intervention and placebo groups. Radiosurgery
was performed for both groups (Reference dose: 16-18 Gray, in one fraction). The intervention group received low
copper diet and penicillamine while the patients in the placebo group continued with their usual diet. VEGF and IL-8
were measured at baseline and the end of intervention. Results: VEGF in intervention group significantly reduced
compared to placebo group (Mean ± SD, 4.5±1.91 vs. 7.8±3.21; P<0.001). IL-8 in intervention group decreased
compared to placebo group but not significant (2.7±1.91 vs. 3.2±3.20; P=0.49). We also detected a significant positive
correlation between serum copper and VEGF (r=0.57; P<0.05) and a negative correlation between KPS and serum
copper. Discussion: Our results could reflect that low copper diet and penicillamine may decrease serum VEGF in
patients who underwent gamma knife radiosurgery for recurrent glioblastoma multiforme.
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