Thermal Therapy Approaches for Treatment of Brain Tumors in Animals and Humans.
Thermal Therapy Approaches for Treatment of Brain Tumors in Animals and Humans.
复制标题
DOI：
10.1615/critrevbiomedeng.2017021249
复制
发表时间：
2016
影响因子：
--
通讯作者：
Haemmerich D
中科院分区：
文献类型：
--
作者：
Bredlau AL;McCrackin MA;Motamarry A;Helke K;Chen C;Broome AM;Haemmerich D
原发脑肿瘤通常具有侵袭性，即使采用手术、化疗和放射治疗等标准护理疗法，确诊后的存活期也很短。热疗作为主要和辅助治疗方法已被广泛研究。尽管热疗尚未广泛应用于临床，但已经有几种有前景的方法在动物和人类身上得到了证明。本文综述了动物和人体研究中的热疗方法，包括热疗(~42°C-45°C)和热消融(~50°C)。热疗主要用于辅助化疗和放射治疗，是研究最广泛的辐射增敏剂，在人类脑癌患者中显示出增强的疗效。热疗还有其他有益的作用，例如免疫原性效应，以及打开血脑屏障以潜在地增强药物输送，例如与纳米药物输送系统相结合。热消融利用高温直接破坏局部肿瘤，并作为激光间质热疗(LIT)进入临床应用。本文介绍了各种热疗和消融方法，包括用于热疗的不同设备和方法，如射频/微波、激光、高强度聚焦超声和磁性纳米颗粒。目前的研究努力包括结合先进的热疗设备，如聚焦超声波和辐射，以及使用热疗来增强化疗通过血脑屏障的传输。
Primary brain tumors are often aggressive, with short survival from time of diagnosis even with standard of care therapies such as surgery, chemotherapy, and radiation therapy. Thermal therapies have been extensively investigated as both primary and adjuvant therapy. Although thermal therapies are not yet widely used clinically, there have been several promising approaches demonstrated in both animals and humans. This review presents thermal therapy approaches in animal and human studies, including both hyperthermia (temperatures ~42°C–45°C) and thermal ablation (temperatures > 50°C). Hyperthermia is primarily used as adjuvant to chemotherapy and radiotherapy, and is the most widely studied radiation sensitizer where enhanced efficacy has been shown in human patients with brain cancer. Hyperthermia has additional beneficial effects such as immunogenic effects, and opening of the blood-brain barrier to potentially enhance drug delivery, for example in combination with nanoparticle drug delivery systems. Thermal ablation uses high temperatures for direct local tumor destruction, and it found its way into clinical use as laser interstitial thermal therapy (LITT). This review presents various hyperthermia and ablation approaches, including a review of different devices and methods that have been used for thermal therapies, such as radiofrequency/microwaves, laser, high-intensity focused ultrasound, and magnetic nanoparticles. Current research efforts include the combination of advanced thermal therapy devices, such as focused ultrasound with radiation, as well as the use of thermal therapies to enhance chemotherapy delivery across the blood-brain barrier.