Johannsen Manfred, Gneveckow Uwe, Taymoorian Kasra, Cho Chie Hee, Thiesen Burghard, Scholz Regina, Waldöfner Norbert, Loening Stefan A, Wust Peter, Jordan Andreas
Department of Urology, Campus Mitte, Charité-Universitätsmedizin Berlin, Alemania.
Actas Urol Esp. 2007 Jun;31(6):660-7. doi: 10.1016/s0210-4806(07)73703-8.
A novel method of interstitial heating using magnetic nanoparticles and a direct injection technique has been evaluated in human cancers in recent clinical trials. In prostate cancer, this approach was investigated in two separate phase-I-studies, employing magnetic nanoparticle thermotherapy alone and in combination with permanent seed brachytherapy. The feasibility and good tolerability was shown in both trials, using the first prototype of a magnetic field applicator. As with any other heating technique, this novel approach requires specific tools for planning, quality control and thermal monitoring, based on appropriate imaging and modelling techniques. In these first clinical trials, a newly developed method for planning and non-invasive calculations of the 3-dimensional temperature distribution based on computed tomography could be validated. Limiting factors of this approach at present are patient discomfort at high magnetic field strengths and suboptimal intratumoral distribution of nanoparticles. Until these limitations will be overcome and thermal ablation can safely be applied as a monotherapy, this treatment modality is being evaluated in combination with irradiation in patients with localized prostate cancer.
最近的临床试验对一种使用磁性纳米颗粒和直接注射技术的间质加热新方法在人类癌症中进行了评估。在前列腺癌中,该方法在两项单独的I期研究中进行了研究,分别采用单独的磁性纳米颗粒热疗以及与永久性粒子近距离放射治疗联合使用。两项试验均使用磁场施加器的首个原型,显示出该方法的可行性和良好的耐受性。与任何其他加热技术一样,这种新方法需要基于适当的成像和建模技术的特定工具来进行规划、质量控制和热监测。在这些首次临床试验中,一种基于计算机断层扫描的新开发的三维温度分布规划和非侵入性计算方法得到了验证。目前该方法的限制因素包括高磁场强度下患者的不适以及纳米颗粒在肿瘤内的分布不理想。在这些限制被克服且热消融能够安全地作为单一疗法应用之前,这种治疗方式正在与局部前列腺癌患者的放疗联合进行评估。