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人类肿瘤的热疗:热致死时间。

Hyperthermic therapy for human neoplasms: thermal death time.

作者信息

Storm F K, Harrison W H, Elliott R S, Morton D L

出版信息

Cancer. 1980 Oct 15;46(8):1849-54. doi: 10.1002/1097-0142(19801015)46:8<1849::aid-cncr2820460824>3.0.co;2-s.

Abstract

Hyperthermia greater than or equal to 42 C is tumoricidal, apparently a function of absolute temperature and duration of heating. However, because the technology for producing safe and effective deep hyperthermia did not exist, there was virtually no data on the thermal death times of human cancers. The development of a fundamentally new radio frequency device that produces uniform hyperthermia to any depth without surface tissue injury has allowed preliminary testing of this hypothesis in 38 patients with advanced cancer. Temperature measurements were taken in tumors and normal adjacent tissues. Tumors were heated from 40 C to greater than or equal to 50 C, one to ten times (13-600 minutes). Serial tumor biopsies compared percent necrosis (total absence of nuclei) by type of therapy. Of 44 tumors evaluated (21 superficial, 23 visceral), 31 (70%) were heated greater than or equal to 42 C, 23 (52%) greater than or equal to 45 C, and 14 (32%) greater than or equal to 50 C, with virtually no normal tissue injury. Single, short duration hyperthermia at greater than or equal to 50 C resulted in 20-100% tumor necrosis, while lower temperatures had no effect. Two or three treatments at 45-50 C produced 70-100% necrosis, while lower temperatures produced less necrosis at more than twice the duration of heating. Multiple treatments produced increased necrosis at lower temperatures; however, at the same temperature duration, higher temperatures were most effective. These clinical results support the hypothesis that the observed necrosis is related to both temperature and treatment time and suggest that higher temperatures and longer durations of therapy are most beneficial.

摘要

体温高于或等于42摄氏度具有杀肿瘤作用,这显然是绝对温度和加热持续时间的函数。然而,由于不存在产生安全有效的深部热疗的技术,实际上没有关于人类癌症热死亡时间的数据。一种全新的射频设备的开发,该设备可在不损伤表面组织的情况下,在任何深度产生均匀的热疗,这使得在38例晚期癌症患者中对这一假设进行了初步测试。在肿瘤和相邻正常组织中进行了温度测量。肿瘤从40摄氏度加热到高于或等于50摄氏度,加热一到十次(13 - 600分钟)。连续的肿瘤活检通过治疗类型比较坏死百分比(细胞核完全缺失)。在评估的44个肿瘤中(21个浅表肿瘤,23个内脏肿瘤),31个(70%)被加热到高于或等于42摄氏度,23个(52%)高于或等于45摄氏度,14个(32%)高于或等于50摄氏度,几乎没有正常组织损伤。单次、短时间高于或等于50摄氏度的热疗导致20 - 100%的肿瘤坏死,而较低温度则没有效果。在45 - 50摄氏度下进行两到三次治疗产生70 - 100%的坏死,而较低温度在加热时间超过两倍时产生的坏死较少。多次治疗在较低温度下产生的坏死增加;然而,在相同的温度持续时间下,较高温度最为有效。这些临床结果支持了观察到的坏死与温度和治疗时间都相关的假设,并表明较高温度和较长治疗持续时间最为有益。

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