Rath-Wolfson Lea, Moskovitz Boaz, Dekel Yoram, Kugel Valentina, Koren Rumelia
Department of Pathology, Hasharon Hospital, Rabin Medical Centre, Petah-Tikva, Israel.
Int J Exp Pathol. 2003 Jun;84(3):145-52. doi: 10.1046/j.1365-2613.2003.00346.x.
Previous clinical studies of the combination of local intravesical hyperthermia with cytostatic drugs for the treatment of Superficial Transitional Cell Carcinoma of the urinary bladder (STCCB) showed encouraging results both in reducing recurrence rate to 20-30% within 2 years and in ablative success rate of 79%. Our objectives were to evaluate bladder tissue and adjacent organs during and following hyperthermia treatment. An intravesical catheter equipped with a radio-frequency antenna (Synergo SB-TS 101.1 System) was used for hyperthermia and intravesical chemotherapy (mitomycin C) was instilled in vivo for 60 min in two anaesthetized sheep. Thirteen to fifteen thermocouples were sewn surgically on the internal and external surfaces of the bladder wall and on adjacent organs to monitor the temperature during the treatment. We expected the intravesical temperature to be under 46 degrees C and the external layers below 45 degrees C. The bladder was filled with 50 mL of chemotherapeutic solution (400 micro g/mL of mitomycin C in distilled water). The sheep were sacrificed at the end of the treatment. Three other sheep, which underwent thoracic surgery, served as control group. Histological changes in both groups showed foci of oedema and haemorrhage with inflammation in the lamina propria and serosa. Foci of desquamation of the epithelium were noticed in the treated sheep. Histological analysis of the treated group showed no significant differences from the control group. The control group showed similar changes, some less pronounced. The combined treatment of hyperthermia with mitomycin C did not cause major damage to the urinary bladder or adjacent organs. All changes were superficial and reversible, and the control group showed similar changes, some less pronounced. Although this is an experimental model based on one single session treatment, rather than repeated treatments, it suggests that the approach may be useful in future studies both in models and man.
先前关于局部膀胱内热疗联合细胞抑制剂治疗浅表性膀胱移行细胞癌（STCCB）的临床研究显示，在将两年内复发率降至20%-30%以及消融成功率达到79%方面都取得了令人鼓舞的结果。我们的目标是评估热疗过程中及热疗后的膀胱组织和邻近器官。使用配备射频天线的膀胱内导管（Synergo SB-TS 101.1系统）进行热疗，并在两只麻醉的绵羊体内灌注膀胱内化疗药物（丝裂霉素C）60分钟。通过手术将13至15个热电偶缝在膀胱壁的内表面和外表面以及邻近器官上，以监测治疗期间的温度。我们预期膀胱内温度低于46摄氏度，外层温度低于45摄氏度。膀胱内注入50毫升化疗溶液（蒸馏水中含400微克/毫升丝裂霉素C）。治疗结束后处死绵羊。另外三只接受胸外科手术的绵羊作为对照组。两组的组织学变化均显示固有层和浆膜有水肿、出血灶及炎症。在接受治疗的绵羊中发现了上皮剥脱灶。治疗组的组织学分析与对照组无显著差异。对照组也有类似变化，只是有些不太明显。热疗联合丝裂霉素C的治疗未对膀胱或邻近器官造成重大损害。所有变化都是浅表且可逆的，对照组也有类似变化，只是有些不太明显。尽管这是一个基于单次治疗而非重复治疗的实验模型，但它表明该方法在未来的模型研究和人体研究中可能会有用。
