Ward K A, Jain R K
Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213-3890.
Int J Hyperthermia. 1988 May-Jun;4(3):223-50. doi: 10.3109/02656738809051100.
The response of both neoplastic and surrounding normal tissue to hyperthermia is influenced by a number of physical, physiological, biological and immunological factors. Two physiological factors that play an important role are blood flow and pH. Temperature distributions within neoplastic and surrounding normal tissue during hyperthermia are influenced by convective heat transfer between the blood and tissue bed. A number of in vitro studies have illustrated that lowering media pH sensitizes cells to hyperthermia. It has been suggested that pharmacological agents could be used in conjunction with hyperthermia treatment to improve cancer treatment if these agents decrease tumour blood flow and/or decrease tumour pH. One agent that has been studied extensively for this purpose is glucose. The objective of this paper is to review the results on the effect of hyperglycaemia on normal and tumour tissue blood flow and pH and its role in hyperthermia. After a brief discussion of the role of tumour pH and blood flow in hyperthermia treatment, data available in the literature on the effect of hyperglycaemia on normal and tumour tissue blood flow and pH are reviewed. Finally, the role of hyperglycaemia in hyperthermia treatment is discussed, and various studies involving the combined treatment are summarized. Key unanswered questions and directions for future research are pointed out.
肿瘤组织和周围正常组织对热疗的反应受到多种物理、生理、生物和免疫因素的影响。其中两个起重要作用的生理因素是血流和pH值。热疗过程中肿瘤组织和周围正常组织内的温度分布受血液与组织床之间对流热传递的影响。多项体外研究表明，降低培养基pH值会使细胞对热疗更敏感。有人提出，如果药物能够减少肿瘤血流和/或降低肿瘤pH值，那么可以将其与热疗联合使用以改善癌症治疗。为此进行了广泛研究的一种药物是葡萄糖。本文的目的是综述高血糖对正常组织和肿瘤组织血流及pH值的影响结果及其在热疗中的作用。在简要讨论肿瘤pH值和血流在热疗中的作用后，回顾了文献中关于高血糖对正常组织和肿瘤组织血流及pH值影响的现有数据。最后，讨论了高血糖在热疗中的作用，并总结了涉及联合治疗的各种研究。指出了关键的未解决问题和未来研究方向。
