Magnetic Nanoparticles-Loaded Poly (Methyl Methacrylate) Bone Cements for Magnetic Hyperthermia Treatment of Bone Tumors: State-of- the-Art Review

Background: Among emerging modalities for the treatment of bone cancers is magnetic hyperthermia treatment (MHT), which, it has been envisaged, will be used as an adjuvant to either of the two well-established ones (surgery and radiotherapy). MHT involves intratumoral or systemic delivery of a suspension of magnetic nanoparticles (MNPs) to the tumor site, and, then, subjecting the site to an externally-generated alternating magnetic field for, typically, 30-60 min. In the recent literature, several shortcomings of MHT have been highlighted, which has led to the proposal of use of a variant of MHT that involves intratumoral injection of a suspension that includes a dough of a MNPs-loaded poly (methyl methacrylate) bone cement (MNPBC) to the site. A review of the literature on MNPBCs is lacking.

Purpose: The present contribution is a comprehensive and critical state-of-the-art review of the literature on MNPBCs.

Methodology: Through an exhaustive search of relevant databases, such as MEDLINE, Google Scholar, and PubMed, articles on MNPBCs published in the English language literature were identified, read, evaluated, and summarized. This allowed many topics to be covered in the present review, among which are characterization of the MNPs used to prepare various formulations of the cement, characterization of the cement formulations, and shortcomings of the literature. The last-mentioned aspect led to recommendations of thirteen topics for future study.

Conclusions: Among the topics recommended for future study are development of a testing standard for determination of in vitro properties of MNPBCs, performance of large-scale parametric studies on an appropriate animal bone tumor model (such as the influence of tumor size, tumor location, shape of the MNPs, and the magnitude and frequency of the applied magnetic field, on various measures of the heat-generation performance of an MNPBC), study of transient heat transfer involved in local MHT, and application of machine learning method(s) to determination of the heat-generation performance of an MNPBC.