Feasibility of removable balloon implant for simultaneous magnetic nanoparticle heating and HDR brachytherapy of brain tumor resection cavities.
Feasibility of removable balloon implant for simultaneous magnetic nanoparticle heating and HDR brachytherapy of brain tumor resection cavities.
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DOI：
10.1080/02656736.2020.1829103
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Hurwitz MD
中科院分区：
文献类型：
--
作者：
Stauffer PR;Rodrigues DB;Goldstein R;Nguyen T;Yu Y;Wan S;Woodward R;Gibbs M;Vasilchenko IL;Osintsev AM;Bar-Ad V;Leeper DB;Shi W;Judy KD;Hurwitz MD
热疗(HT)已被证明可以改善癌症放射治疗(RT)的临床反应。如果同时联合应用HT和RT，协同作用将显著增强，但尚不存在同时应用治疗的适当技术。这项研究探讨了使用临时的近距离热疗(TBT)球囊植入物，在肿瘤切除腔周围5-10 mm的高危组织环状边缘进行放射治疗的可行性。设计了一种球囊导管，通过在球囊中填充磁性纳米颗粒(MNP)并将其浸入射频磁场中，在高剂量率(HDR)近距离放射治疗的同时提供放射。用数值模拟的方法模拟了TBT气球周围的温度分布，并利用温度依赖的脑血流灌流模拟了气球周围的温度分布。建立了一个磁感应系统，用于在133 kHz的5.7kA/m磁场中吸收0.5W/ml的磁感应产生快速加热(>；0.2°C/S)脑组织等效体模中填充了MnP的气球。模拟治疗计划演示了使用直径2-5厘米的气囊在40-48°C之间加热脑瘤切除腔周围有风险的组织的能力。实验热剂量学验证了在先前的临床研究中已被证明安全的磁场强度下，脑模在MNP填充的球囊周围预期的快速且球对称的加热。这些临床前研究结果证明了使用TBT球囊在HDR近距离放射治疗的同时将热输送到脑瘤切除腔周围的肿瘤床上的可行性，与以前的多导管间质方法相比，加热的均匀性显著提高。与之前的临床热放射治疗试验结果一起考虑，这种新的能力有望改善多形性胶质母细胞瘤患者的存活率和生活质量。
Hyperthermia (HT) has been shown to improve clinical response to radiation therapy (RT) for cancer. Synergism is dramatically enhanced if HT and RT are combined simultaneously, but appropriate technology to apply treatments together does not exist. This study investigates the feasibility of delivering HT with RT to a 5-10mm annular rim of at-risk tissue around a tumor resection cavity using a temporary thermobrachytherapy (TBT) balloon implant. A balloon catheter was designed to deliver radiation from High Dose Rate (HDR) brachytherapy concurrent with HT delivered by filling the balloon with magnetic nanoparticles (MNP) and immersing it in a radiofrequency magnetic field. Temperature distributions in brain around the TBT balloon were simulated with temperature dependent brain blood perfusion using numerical modeling. A magnetic induction system was constructed and used to produce rapid heating (>0.2°C/s) of MNP-filled balloons in brain tissue-equivalent phantoms by absorbing 0.5 W/ml from a 5.7 kA/m field at 133 kHz. Simulated treatment plans demonstrate the ability to heat at-risk tissue around a brain tumor resection cavity between 40-48°C for 2-5cm diameter balloons. Experimental thermal dosimetry verifies the expected rapid and spherically symmetric heating of brain phantom around the MNP-filled balloon at a magnetic field strength that has proven safe in previous clinical studies These preclinical results demonstrate the feasibility of using a TBT balloon to deliver heat simultaneously with HDR brachytherapy to tumor bed around a brain tumor resection cavity, with significantly improved uniformity of heating over previous multi-catheter interstitial approaches. Considered along with results of previous clinical thermobrachytherapy trials, this new capability is expected to improve both survival and quality of life in patients with glioblastoma multiforme.
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DOI：
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发表时间：
2005-07-15
影响因子：
7
作者：
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影响因子：
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发表时间：
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影响因子：
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影响因子：
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