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Addressing radiotherapy-induced fibrosis: the potential of platelet-rich plasma and infliximab for improved breast cancer management

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Abstract

Breast cancer treatment encompasses various therapeutic modalities, including surgery, radiotherapy, and chemotherapy. Breast-conserving surgery has been an integral part of breast cancer management. However, radiotherapy, an important component of breast cancer management, can lead to complications, particularly fibrosis, affecting reconstructive surgery outcomes. We conducted an in vivo study using 48 female Wistar Albino rats, employing segmental mastectomy and radiotherapy to simulate post-mastectomy conditions. The rats were divided into six groups: control, mastectomy, mastectomy + radiotherapy, mastectomy + platelet-rich plasma (PRP) + radiotherapy, mastectomy + infliximab + radiotherapy, and mastectomy + infliximab + PRP + radiotherapy. Edema, hyperemia, inflammation, and fibrosis were assessed as indicators of tissue response. Histopathological analysis revealed that mastectomy + infliximab and mastectomy + infliximab + PRP groups showed significant reductions in fibrosis compared to other groups. Edema, hyperemia, and inflammation were also less severe in these groups compared to the control group. Radiotherapy-induced fibrosis is a major concern in breast reconstruction. Our study suggests that local PRP application and systemic infliximab administration, either alone or in combination, could mitigate the adverse effects of radiotherapy. This approach has the potential to improve reconstructive outcomes in patients undergoing or having the possibility to undergo radiotherapy. This is the first study showing the effectiveness of infliximab and PRP combination on wound healing. The provided experimental rat model might offer guidance for further research. This study provides insights into optimizing outcomes in reconstructive breast surgery, paving the way for further research and clinical studies.

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No funding was received for the research presented in this manuscript.

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Study conception and design: SB and ÜHİ; data collection: SB, MG, ZAİ, BD and SU analysis and interpretation of results: SB, MG, AÖ, ZAİ, BD and ÜHİ draft manuscript preparation: SB, MG, AÖ, SU, and ÜHİ. All authors reviewed the results and approved the final version of the manuscript.

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Correspondence to Serhat Binici.

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There are no competing interests or conflicts of interest to disclose regarding this study.

Ethics approval

Ethical approval for this research was obtained from the Van Yüzüncü Yıl University Animal Experiments Local Ethics Committee of Van Yüzüncü Yıl University under protocol number 2021/10-12. All experimental procedures were conducted in strict adherence to ethical guidelines.

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Binici, S., Güven, M., Özdemir, A. et al. Addressing radiotherapy-induced fibrosis: the potential of platelet-rich plasma and infliximab for improved breast cancer management. Histochem Cell Biol 161, 381–389 (2024). https://doi.org/10.1007/s00418-024-02267-z

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  • DOI: https://doi.org/10.1007/s00418-024-02267-z

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