Hyperthermic therapy for human neoplasms: Thermal death time
Hyperthermic therapy for human neoplasms: Thermal death time
复制标题
人类肿瘤的热疗：热死亡时间
作者：
F. Storm;W. Harrison;R. Elliott;D. Morton
≥ 42 ℃的高温是杀肿瘤的，显然是绝对温度和加热时间的函数.然而，由于不存在产生安全有效的深度高温的技术，几乎没有关于人类癌症热死亡时间的数据。一种全新的射频设备的开发，可以在任何深度产生均匀的热疗，而不会损伤表面组织，已经在38名晚期癌症患者中对这一假设进行了初步测试。在肿瘤和正常邻近组织中进行温度测量。将肿瘤从40 ℃加热至≥ 50 ℃，1至10次（13-600分钟）。系列肿瘤活检比较了不同治疗类型的坏死百分比（细胞核完全缺失）。在评价的44个肿瘤（21个浅表，23个内脏）中，31个（70%）加热≥ 42 C，23个（52%）≥45 C，14个（32%）≥ 50 C，几乎没有正常组织损伤。在≥ 50 ℃下的单次短时间高温导致20-100%的肿瘤坏死，而较低的温度则没有影响。在45-50 ℃下进行两次或三次处理产生70-100%的坏死，而较低的温度在加热持续时间的两倍以上产生较少的坏死。多次处理在较低温度下产生坏死增加;然而，在相同的温度持续时间下，较高的温度是最有效的。这些临床结果支持观察到的坏死与温度和治疗时间相关的假设，并表明较高的温度和较长的治疗时间是最有益的。
Hyperthermia ≥ 42 C is tumoricidal, apparently a function of absolute temperature and duration of heating. However, because the technology for producing safe and effective deep hyperthermia did not exist, there was virtually no data on the thermal death times of human cancers. The development of a fundamentally new radio frequency device that produces uniform hyperthermia to any depth without surface tissue injury has allowed preliminary testing of this hypothesis in 38 patients with advanced cancer. Temperature measurements were taken in tumors and normal adjacent tissues. Tumors were heated from 40 C to ≥ 50 C, one to ten times (13–600 minutes). Serial tumor biopsies compared percent necrosis (total absence of nuclei) by type of therapy. Of 44 tumors evaluated (21 superficial, 23 visceral), 31 (70%) were heated ≥ 42 C, 23 (52%) ≥45 C, and 14 (32%) ≥ 50 C, with virtually no normal tissue injury. Single, short duration hyperthermia at ≥ 50 C resulted in 20–100% tumor necrosis, while lower temperatures had no effect. Two or three treatments at 45–50 C produced 70–100% necrosis, while lower temperatures produced less necrosis at more than twice the duration of heating. Multiple treatments produced increased necrosis at lower temperatures; however, at the same temperature duration, higher temperatures were most effective. These clinical results support the hypothesis that the observed necrosis is related to both temperature and treatment time and suggest that higher temperatures and longer durations of therapy are most beneficial.