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基于当前实践和疗效模型,对间质内给予磁性流体进行治疗性热疗的临床和临床前剂量限制的评论。

Commentary on the clinical and preclinical dosage limits of interstitially administered magnetic fluids for therapeutic hyperthermia based on current practice and efficacy models.

机构信息

a Resonant Circuits Limited , London , UK.

b Healthcare Biomagnetics Laboratory , University College London , London , UK.

出版信息

Int J Hyperthermia. 2018 Sep;34(6):671-686. doi: 10.1080/02656736.2017.1365953. Epub 2017 Oct 18.


DOI:10.1080/02656736.2017.1365953
PMID:29046072
Abstract

We offer a critique of what constitutes a suitable dosage limit, in both clinical and preclinical studies, for interstitially administered magnetic nanoparticles in order to enable therapeutic hyperthermia under the action of an externally applied alternating magnetic field. We approach this first from the perspective of the currently approved clinical dosages of magnetic nanoparticles in the fields of MRI contrast enhancement, sentinel node detection, iron replacement therapy and magnetic thermoablation. We compare this to a simple analytical model of the achievable hyperthermia temperature rise in both humans and animals based on the interstitially administered dose, the heating and dispersion characteristics of the injected fluid, and the strength and frequency of the applied magnetic field. We show that under appropriately chosen conditions a therapeutic temperature rise is achievable in clinically relevant situations. We also show that in such cases it may paradoxically be harder to achieve the same therapeutic temperature rise in a preclinical model. We comment on the implications for the evidence-based translation of hyperthermia based interventions from the laboratory to the clinic.

摘要

我们对临床和临床前研究中适用于间质给药的磁性纳米粒子的剂量限制进行了评价,以便在外加交变磁场作用下实现治疗性热疗。我们首先从 MRI 对比增强、前哨淋巴结检测、铁替代治疗和磁热消融等领域中已批准的临床磁性纳米粒子剂量的角度来探讨这个问题。我们将这与基于间质给药剂量、注入液体的加热和弥散特性以及外加磁场强度和频率的人类和动物体内可实现的热疗升温的简单分析模型进行了比较。我们表明,在适当选择的条件下,在临床相关情况下可以实现治疗性升温。我们还表明,在这种情况下,在临床前模型中实现相同的治疗性升温可能更具挑战性。我们对基于实验室的热疗干预措施向临床转化的循证研究的意义进行了评论。

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