Clinical hyperthermia of prostate cancer using magnetic nanoparticles:: Presentation of a new interstitial technique
Clinical hyperthermia of prostate cancer using magnetic nanoparticles:: Presentation of a new interstitial technique
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DOI：
10.1080/02656730500158360
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发表时间：
2005-11-01
影响因子：
3.1
通讯作者：
Jordan, A
中科院分区：
文献类型：
--
作者：
Johannsen, M;Gneveckow, U;Jordan, A
本研究的目的是评估磁流体热疗技术是否可用于前列腺癌的微创治疗。本文介绍了使用磁性纳米粒子的间质热疗在局部复发性前列腺癌中的首次临床应用。使用前列腺计算机断层扫描（CT）进行治疗计划。基于前列腺的个体解剖结构和估计的特定吸收率（SAR）的磁流体在前列腺组织中，足够的热沉积所需的磁流体仓库的数量和位置计算，而直肠和尿道是备用的。在经直肠超声和荧光镜引导下经会阴将纳米颗粒悬浮液注射到前列腺中。在用于人类的第一个磁场施加器中进行治疗，使用频率为100 kHz和可变场强（0-18 kAm（-1））的交流磁场。前列腺的侵入性测温进行了第一次和最后一次的六个每周60分钟的持续时间的热疗会议。在第一次和最后一次高温治疗后重复前列腺的CT扫描，以记录磁性纳米颗粒分布和测温探针在前列腺中的位置。在6周的治疗间隔期间，纳米颗粒保留在前列腺中。使用适当的软件（AMIRA），可以基于磁性纳米颗粒的肿瘤内分布来执行前列腺中的温度值的非侵入性估计，并将其与侵入性测量的前列腺内温度相关联。使用专门设计的冷却装置，治疗耐受性良好，无需麻醉。在接受治疗的第一例患者中，在场强为4.0-5.0 kAm（-1）时测量的前列腺内最高和最低温度在第1次治疗期间分别为48.5 ℃和40.0 ℃，在第6次治疗期间分别为42.5 ℃和39.4 ℃。这些第一次临床经验促使我们启动了一项I期研究，以评估使用磁性纳米粒子在具有根治性放疗后活检证实的前列腺癌局部复发患者中进行热疗的可行性，毒性和生活质量。据作者所知，这是第一份关于使用磁性纳米颗粒进行间质热疗治疗人类癌症的临床应用报告。
The aim of this pilot study was to evaluate whether the technique of magnetic fluid hyperthermia can be used for minimally invasive treatment of prostate cancer. This paper presents the first clinical application of interstitial hyperthermia using magnetic nanoparticles in locally recurrent prostate cancer. Treatment planning was carried out using computerized tomography (CT) of the prostate. Based on the individual anatomy of the prostate and the estimated specific absorption rate (SAR) of magnetic fluids in prostatic tissue, the number and position of magnetic fluid depots required for sufficient heat deposition was calculated while rectum and urethra were spared. Nanoparticle suspensions were injected transperineally into the prostate under transrectal ultrasound and flouroscopy guidance. Treatments were delivered in the first magnetic field applicator for use in humans, using an alternating current magnetic field with a frequency of 100 kHz and variable field strength (0-18 kAm(-1)). Invasive thermometry of the prostate was carried out in the first and last of six weekly hyperthermia sessions of 60 min duration. CT-scans of the prostate were repeated following the first and last hyperthermia treatment to document magnetic nanoparticle distribution and the position of the thermometry probes in the prostate. Nanoparticles were retained in the prostate during the treatment interval of 6 weeks. Using appropriate software (AMIRA), a non-invasive estimation of temperature values in the prostate, based on intra-tumoural distribution of magnetic nanoparticles, can be performed and correlated with invasively measured intra-prostatic temperatures. Using a specially designed cooling device, treatment was well tolerated without anaesthesia. In the first patient treated, maximum and minimum intra-prostatic temperatures measured at a field strength of 4.0-5.0 kAm(-1) were 48.5 degrees C and 40.0 degrees C during the 1st treatment and 42.5 degrees C and 39.4 degrees C during the 6th treatment, respectively. These first clinical experiences prompted us to initiate a phase I study to evaluate feasibility, toxicity and quality of life during hyperthermia using magnetic nanoparticles in patients with biopsy-proven local recurrence of prostate cancer following radiotherapy with curative intent. To the authors' knowledge, this is the first report on clinical application of interstitial hyperthermia using magnetic nanoparticles in the treatment of human cancer.