Okumura Y
Gan To Kagaku Ryoho. 1983 Apr;10(4 Pt 1):886-93.
The effects of hyperthermia on tumor cells and the mechanism of radiosensitization by hyperthermia were analysed. The clinical application of hyperthermia to cancer treatment was also discussed. The heat sensitivity of cells was dependent on the exposed period and temperature. The increase in one degree Celsius of temperature enhanced twice the heat sensitivity of cells. The target of cell killing might be proteins which are associated with the membrane-energy system. The heat sensitivity was increased at low pH. A large tumor (e. g., 800 mm3 of volume) responded more to hyperthermia than a small tumor (e. g., 30 mm3). This could be explained that the large tumor contains nencosis and many low-pH cells. Repeated treatment of hyperthermia induced heat-tolerance. The same effects of hyperthermia to the tumor cells were observed on normal tissues as well. The clinical application of hyperthermia can be evaluated by the therapeutic ratio. With animal tumors, 1.5 of the therapeutic ratio was obtained. By combining hyperthermia with irradiation, the radiation effect of cell killing was enhanced. The radiosensitization increased with the temperature of hyperthermia. The mechanism of radiosensitization is due to inhibition of repair from sublethal damage and potentially lethal damage. Clinical evaluation of the combination of two modalities was done by the therapeutic gain factor. Irradiation followed by hyperthermia resulted in more than unity of the therapeutic gain factor. It might be concluded that hyperthermia can be applied to large tumor clinically, and that the treatment of hyperthermia can be applied after 2 to 4 hours of irradiation when combined.
分析了热疗对肿瘤细胞的影响以及热疗增敏的机制。还讨论了热疗在癌症治疗中的临床应用。细胞的热敏感性取决于暴露时间和温度。温度每升高1摄氏度,细胞的热敏感性增强两倍。细胞杀伤的靶点可能是与膜能量系统相关的蛋白质。在低pH值下热敏感性增加。大肿瘤(例如体积为800立方毫米)比小肿瘤(例如30立方毫米)对热疗的反应更大。这可以解释为大肿瘤含有坏死组织和许多低pH值细胞。重复进行热疗会诱导热耐受。热疗对肿瘤细胞的同样影响在正常组织中也能观察到。热疗的临床应用可以通过治疗比来评估。对于动物肿瘤,获得了1.5的治疗比。通过将热疗与放疗相结合,细胞杀伤的放射效应增强。增敏作用随着热疗温度的升高而增加。增敏机制是由于抑制了亚致死损伤和潜在致死损伤的修复。两种治疗方式联合应用的临床评估通过治疗增益因子来进行。先放疗后热疗导致治疗增益因子大于1。可以得出结论,热疗可在临床上应用于大肿瘤,并且在联合应用时,热疗可在放疗2至4小时后进行。