University of Toledo Medical Center, Toledo, OH 43614, USA.
Med Phys. 2012 Apr;39(4):1980-90. doi: 10.1118/1.3693048.
Studies of the curative effects of hyperthermia and radiation therapy on treatment of cancer show a strong evidence of a synergistic enhancement when both radiation and hyperthermia modalities are applied simultaneously. Varieties of tissue heating approaches developed up to date still fail to overcome such essential limitations as an inadequate temperature control, temperature nonuniformity, and prolonged time delay between hyperthermia and radiation treatments. The authors propose a new self-regulating thermobrachytherapy seed, which serves as a source of both radiation and heat for concurrent administration of brachytherapy and hyperthermia.
The proposed seed is based on the BEST Medical, Inc., Seed Model 2301-I(125), where tungsten marker core and the air gap are replaced with a ferromagnetic material. The ferromagnetic core produces heat when subjected to alternating electromagnetic (EM) field and effectively shuts off after reaching the Curie temperature (T(C)) of the ferromagnetic material thus realizing the temperature self-regulation. The authors present a Monte Carlo study of the dose rate constant and other TG-43 factors for the proposed seed. For the thermal characteristics, the authors studied a model consisting of 16 seeds placed in the central region of a cylindrical water phantom using a finite-element partial differential equation solver package "COMSOL Multiphysics."
The modification of the internal structure of the seed slightly changes dose rate and other TG-43 factors characterizing radiation distribution. The thermal modeling results show that the temperature of the thermoseed surface rises rapidly and stays constant around T(C) of the ferromagnetic material. The amount of heat produced by the ferromagnetic core is sufficient to raise the temperature of the surrounding phantom to the therapeutic range. The phantom volume reaching the therapeutic temperature range increases with increase in frequency or magnetic field strength.
An isothermal distribution matching with the radiation isodose distribution can be achieved within a target volume by tuning frequency and intensity of the alternating magnetic field. The proposed combination seed model has a potential for implementation of concurrent brachytherapy and hyperthermia.
对热疗和放疗治疗癌症的疗效进行的研究表明,当同时应用放疗和热疗这两种方法时,会产生协同增强作用,这一作用具有很强的证据支持。迄今为止开发的各种组织加热方法仍然存在一些基本限制,如温度控制不足、温度不均匀以及热疗和放疗之间的时间延迟过长。作者提出了一种新的自调节热近距放疗种子,该种子既是放疗的辐射源,也是热疗的热源,可以同时进行近距离放疗和热疗。
所提出的种子基于 BEST Medical, Inc. 的 Seed Model 2301-I(125),其中钨标记芯和空气隙被铁磁材料取代。铁磁芯在受到交变电磁场作用时会产生热量,并在达到铁磁材料的居里温度(T(C))时有效关闭,从而实现温度的自我调节。作者对所提出的种子的剂量率常数和其他 TG-43 因子进行了蒙特卡罗研究。对于热特性,作者使用有限元偏微分方程求解器包“COMSOL Multiphysics”研究了由放置在圆柱形水模体中心区域的 16 个种子组成的模型。
种子内部结构的改变会略微改变剂量率和其他描述辐射分布的 TG-43 因子。热模拟结果表明,热种子表面的温度迅速升高,并保持在铁磁材料的居里温度附近。铁磁芯产生的热量足以将周围的水模体温度升高到治疗范围。达到治疗温度范围的水模体体积随着频率或磁场强度的增加而增加。
通过调整交变磁场的频率和强度,可以在靶体积内实现与辐射等剂量分布相匹配的等温分布。所提出的组合种子模型具有实现同时近距离放疗和热疗的潜力。