[A bone cement containing methotrexate in an experiment and in clinical practice]

Area of Science:

• Oncology
• Biomaterials Science
• Pharmacology

Context:

• Bone cement is widely used in orthopedic surgery.
• Methotrexate is a chemotherapy drug with anti-cancer properties.
• Combining bone cement with chemotherapy offers a potential localized treatment strategy for bone malignancies.

Purpose:

• To evaluate the stability and release kinetics of methotrexate from bone cement in vitro.
• To assess the effects of methotrexate-loaded bone cement on adjacent bone tissue in an animal model.
• To report the initial clinical experience with bone cement containing methotrexate for treating primary and secondary bone tumors.

Summary:

• In vitro experiments confirmed methotrexate's stability and characterized its release from bone cement.
• Animal studies showed initial bone necrosis followed by healing around the cement.
• Clinical application in 17 patients demonstrated a low rate (1/17) of local tumor progression since 1986.

Impact:

• This research explores a novel localized therapy for bone cancers, particularly metastatic disease.
• The findings suggest bone cement with methotrexate could enhance therapeutic options beyond emergency palliation.
• Further investigation may lead to improved treatment modalities for bone malignancies, reducing systemic toxicity.