Long duration mild temperature hyperthermia and brachytherapy
Long duration mild temperature hyperthermia and brachytherapy
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DOI：
10.1080/02656730310001609335
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发表时间：
2004-03-01
影响因子：
3.1
通讯作者：
Raaphorst, GP
中科院分区：
文献类型：
--
作者：
Armour, EP;Raaphorst, GP
结合长时间低温热疗（LDMH）和低剂量率（LDR）近距离放射治疗，以提高治疗性杀伤癌细胞是多年前提出的。支持这一假设的细胞和肿瘤研究在这篇综述中提出。描述LDMH与脉冲近距离放射治疗和使用临床相关参数的高剂量率近距离放射治疗相互作用的研究与LDMH/LDR近距离放射治疗进行了比较。LDMH敏化LDR的机制已被确定为抑制亚致死损伤修复。分子机制已被证明涉及DNA修复酶，但这些过程的确切性质仍在调查中。LDMH与人类和啮齿动物细胞之间的相互作用的相对差异，以帮助在临床应用中的可能作用的理解。还介绍了LDMH在修改肿瘤血流中的作用及其在肿瘤LDR敏化中的可能作用。LDMH-近距离放射治疗在临床应用中的积极方面有六个方面;（1）热目标（温度、时间和体积）是用目前可用的技术可实现的，（2）热疗本身没有可检测的毒性作用，（3）热耐受性似乎在辐射敏化中起次要作用（如果有的话），（4）可以预期约2的TER，（5）血流改变可降低缺氧分数;（6）同时化疗也可增敏。联合LDMH和近距离放射治疗是一种癌症治疗，已建立了生物学原理和足够的技术和临床进步，可适当应用。这种模式已经成熟，可以进行临床试验。
Combining long duration mild temperature hyperthermia (LDMH) and low dose-rate (LDR) brachytherapy to enhance therapeutic killing of cancer cells was proposed many years ago. The cellular and tumour research that supports this hypothesis is presented in this review. Research describing LDMH interaction with pulsed brachytherapy and high dose-rate brachytherapy using clinically relevant parameters are compared with LDMH/LDR brachytherapy. The mechanism by which LDMH sensitizes LDR has been established as the inhibition of sublethal damage repair. The molecular mechanisms have been shown to involve DNA repair enzymes, but the exact nature of these processes is still under investigation. The relative differences between LDMH interactions with human and rodent cells are presented to help in the understanding of possible roles of LDMH in clinical application. The role of LDMH in modifying tumour blood flow and its possible role in LDR sensitization of tumours is also presented. The positive aspects of LDMH-brachytherapy for clinical application are sixfold; (1) the thermal goals (temperature, time and volume) are achievable with currently available technology, (2) the hyperthermia by itself has no detectable toxic effects, (3) thermotolerance appears to play a minor if any role in radiation sensitization, (4) TER of around 2 can be expected, (5) hypoxic fraction may be decreased due to blood flow modification and (6) simultaneous chemotherapy may also be sensitized. Combined LDMH and brachytherapy is a cancer therapy that has established biological rationale and sufficient technical and clinical advancements to be appropriately applied. This modality is ripe for clinical testing.