Dietz A, Rudat V, Vanselow B, Wollensack P, Bettscheider C, Conradt C, Eble M J
Department of Otolaryngology-Head and Neck Surgery, University of Heidelberg, Germany.
Otolaryngol Head Neck Surg. 1999 Dec;121(6):789-96. doi: 10.1053/hn.1999.v121.a91545.
It has been hypothesized that during radiation treatment a reoxygenation of hypoxic tumor tissue takes place. To test this hypothesis, we have investigated whether reoxygenation in lymph node metastases could be determined by invasive PO (2) measurements. Through a hypodermic needle inserted transcutaneously into tumor-positive lymph nodes, polarographic oxygen determinations were made in 18 patients with advanced squamous cell carcinomas of the oropharynx and hypopharynx. These measurements were performed before therapy and a week after the onset of radiotherapy or radiochemotherapy, respectively. Low PO (2) values before treatment (mean value of the patient's median was 12.6 mm Hg PO (2)) and a mean hypoxic fraction (PO (2) < 5 mm Hg) of 39.6% indicated manifest tumor hypoxia. After 1 week of treatment, a significant increase in the median PO (2) (mean value of shift: 7.3 mm Hg) and a reduction in the hypoxic fraction (mean value of shift: 13.4% PO (2) < 5 mm Hg, P < 0.03) were observed after both radiotherapy and radiochemotherapy. Thus invasive PO (2) histography fulfills the requirements for a method to confirm tumor hypoxia in head and neck tumors. The results obtained indicate that reoxygenation occurs during the initial phases of radiotherapy and radiochemotherapy, and they will form the basis for future comparative investigations on the possible influence of hypoxic parameters on tumor responsiveness toward radiation and radiochemotherapy.
据推测，在放射治疗期间，缺氧肿瘤组织会发生再氧合。为了验证这一假设，我们研究了是否可以通过有创性的PO₂测量来确定淋巴结转移灶中的再氧合情况。通过经皮插入肿瘤阳性淋巴结的皮下针，对18例晚期口咽和下咽鳞状细胞癌患者进行了极谱法氧测定。这些测量分别在治疗前以及放疗或放化疗开始后一周进行。治疗前的低PO₂值（患者中位数的平均值为12.6 mmHg PO₂）和39.6%的平均缺氧分数（PO₂ < 5 mmHg）表明存在明显的肿瘤缺氧。治疗1周后，放疗和放化疗后均观察到中位数PO₂显著增加（平均变化值：7.3 mmHg）以及缺氧分数降低（平均变化值：13.4%，PO₂ < 5 mmHg，P < 0.03）。因此，有创性PO₂组织学符合确认头颈部肿瘤缺氧方法的要求。所获得的结果表明，再氧合发生在放疗和放化疗的初始阶段，它们将为未来关于缺氧参数对肿瘤对放疗和放化疗反应性可能影响的比较研究奠定基础。
