Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie 514-8507, Japan.
Int J Clin Oncol. 2011 Apr;16(2):101-8. doi: 10.1007/s10147-011-0217-3. Epub 2011 Mar 4.
Patients with bone metastases in the extremities sometimes require surgical intervention to prevent deterioration of quality of life due to a pathological fracture. The use of localized radiotherapy combined with surgical reinforcement has been a gold standard for the treatment of bone metastases. However, radiotherapy sometimes induces soft tissue damage, including muscle induration and joint contracture. Moreover, cancer cells are not always radiosensitive. Hyperthermia has been studied since the 1940s using an experimental animal model to treat various types of advanced cancer, and studies have now reached the stage of clinical application, especially in conjunction with radiotherapy or chemotherapy. Nevertheless, bone metastases have several special properties which discourage oncologists from developing hyperthermic therapeutic strategies. First, the bone is located deep in the body, and has low thermal conductivity due to the thickness of cortical bone and the highly vascularized medulla. To address these issues, we developed new hyperthermic strategies which generate heat using magnetic materials under an alternating electromagnetic field, and started clinical application of this treatment modality. The purpose of this review is to summarize the latest studies on hyperthermic treatment in the field of musculoskeletal tumors, and to introduce the treatment strategy employing our novel hyperthermia approach.
对于四肢骨转移的患者,有时需要手术干预,以防止因病理性骨折而导致生活质量下降。局部放疗联合手术强化已成为治疗骨转移的金标准。然而,放疗有时会引起软组织损伤,包括肌肉硬结和关节挛缩。此外,癌细胞并不总是对放疗敏感。自 20 世纪 40 年代以来,人们一直在使用实验动物模型研究热疗来治疗各种类型的晚期癌症,目前研究已经进入临床应用阶段,尤其是与放疗或化疗联合应用。然而,骨转移具有一些特殊性质,这使得肿瘤学家不愿开发热疗策略。首先,骨骼位于身体深部,由于皮质骨的厚度和富含血管的骨髓,其热导率较低。为了解决这些问题,我们开发了新的热疗策略,即在交变电磁场下使用磁性材料产生热量,并开始将这种治疗方式应用于临床。本文旨在总结肌肉骨骼肿瘤领域热疗的最新研究,并介绍我们采用的新型热疗方法。