title: Visible tumor surface response to physical plasma and apoptotic cell kill in head and neck cancer.
abstract: The aim of the study was to learn, whether clinical application of cold atmospheric pressure plasma (CAP) is able to cause (i) visible tumor surface effects and (ii) apoptotic cell kill in squamous cell carcinoma and (iii) whether CAP-induced visible tumor surface response occurs as often as CAP-induced apoptotic cell kill. Twelve patients with advanced head and neck cancer and infected ulcerations received locally CAP followed by palliative treatment. Four of them revealed tumor surface response appearing 2 weeks after intervention. The tumor surface response expressed as a flat area with vascular stimulation (type 1) or a contraction of tumor ulceration rims forming recesses covered with scabs, in each case surrounded by tumor tissue in visible progress (type 2). In parallel, 9 patients with the same kind of cancer received CAP before radical tumor resection. Tissue specimens were analyzed for apoptotic cells. Apoptotic cells were detectable and occurred more frequently in tissue areas previously treated with CAP than in untreated areas. Bringing together both findings and placing side by side the frequency of clinical tumor surface response and the frequency of analytically proven apoptotic cell kill, detection of apoptotic cells is as common as clinical tumor surface response. There was no patient showing signs of an enhanced or stimulated tumor growth under influence of CAP. CAP was made applicable by a plasma jet, kINPen(®) MED (neoplas tools GmbH, Greifswald, Germany).
authors: Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany. Electronic address: schusterm@uni-greifswald.de.
authors: Matthias
authors: M
authors: Schuster
authors: Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany; Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany.
authors: Christian
authors: C
authors: Seebauer
authors: Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany.
authors: Rico
authors: R
authors: Rutkowski
authors: Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany.
authors: Anna
authors: A
authors: Hauschild
authors: Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany.
authors: Fred
authors: F
authors: Podmelle
authors: Greifswald University Medicine, Department of Anesthesiology, Anesthesia, Intensive Care-, Emergency- and Pain Medicine, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany.
authors: Camilla
authors: C
authors: Metelmann
authors: Greifswald University Medicine, Department of Anesthesiology, Anesthesia, Intensive Care-, Emergency- and Pain Medicine, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany.
authors: Bibiana
authors: B
authors: Metelmann
authors: Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; National Centre for Plasma Medicine (ZPM), Charitéplatz 1, 10117 Berlin, Germany.
authors: Thomas
authors: T
authors: von Woedtke
authors: Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany.
authors: Sybille
authors: S
authors: Hasse
authors: Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; National Centre for Plasma Medicine (ZPM), Charitéplatz 1, 10117 Berlin, Germany.
authors: Klaus-Dieter
authors: KD
authors: Weltmann
authors: Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany; National Centre for Plasma Medicine (ZPM), Charitéplatz 1, 10117 Berlin, Germany.
authors: Hans-Robert
authors: HR
authors: Metelmann
mesh_terms: D000328:Adult; D000368:Aged; D017209:Apoptosis; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D058626:Plasma Gases / Q000627:therapeutic use*
chemical_list: D058626:Plasma Gases
keywords: Apoptotic cell kill; Cold atmospheric pressure plasma (CAP); Decontamination; Head and neck cancer; Palliative medicine; Tumor growth