Haveman J, Sminia P, Wondergem J, van der Zee J, Hulshof M C C M
Department of Radiotherapy, Academisch Medisch Centrum, Amsterdam, The Netherlands.
Int J Hyperthermia. 2005 Aug;21(5):473-87. doi: 10.1080/02656730500159079.
Animal studies show that nervous tissue is sensitive to heat. Although inter-species variations may play a role, the data indicate that the maximum heat dose without obvious complications after localized hyperthermia in regions of the central nervous system (CNS) lies in the range of 40-60 min at 42-42.5 degrees C or 10-30 min at 43 degrees C. Expression of thermotolerance after a 'conditioning' heat dose was clearly observed in the spinal cord of rodents and the thermotolerance ratio's (ratio between heat doses with and without conditioning required to obtain a certain defined effect) were high, approximately 2. The thermotolerant state of CNS is shown to protect also against other types of injury as well: pre-treatment of rats with hyperthermia protected against spinal cord ischemic injury. During the rather long period required for temperature elevation which is inherent to WBH, some degree of thermotolerance may develop. The correlation between thermotolerance and hsp70 induction in CNS is obvious. Heat, at least if applied shortly after X-rays, enhances the response of nervous tissue to radiation. Data on the combined effects of X-ray irradiation and hyperthermia on rodent spinal cord clearly show that the radiation response can be enhanced with a factor of 1.1-1.3. There are no clear experimental data indicating an increase in adverse effects specific to the CNS after localized or whole body hyperthermia as a result of combined treatment with chemotherapy.
动物研究表明，神经组织对热敏感。尽管种间差异可能起作用，但数据表明，中枢神经系统（CNS）局部热疗后无明显并发症的最大热剂量为42 - 42.5摄氏度下40 - 60分钟或43摄氏度下10 - 30分钟。在啮齿动物的脊髓中清楚地观察到“预处理”热剂量后热耐受性的表达，且热耐受比（为获得某种特定效果所需的有预处理和无预处理的热剂量之比）很高，约为2。中枢神经系统的热耐受状态也显示出对其他类型损伤的保护作用：对大鼠进行热预处理可预防脊髓缺血性损伤。在全身热疗固有的较长升温期内，可能会产生一定程度的热耐受性。中枢神经系统中热耐受性与热休克蛋白70诱导之间的相关性很明显。热，至少在X射线照射后不久施加时，会增强神经组织对辐射的反应。关于X射线照射和热疗对啮齿动物脊髓联合作用的数据清楚地表明，辐射反应可增强1.1 - 1.3倍。没有明确的实验数据表明局部或全身热疗与化疗联合治疗后中枢神经系统特有的不良反应会增加。
