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通过髓内钉的射频感应加热对犬胫骨进行热疗:一种用于转移性骨肿瘤热疗的新实验方法。

Hyperthermic treatment of canine tibia through RF inductive heating of an intramedullary nail: a new experimental approach to hyperthermia for metastatic bone tumours.

作者信息

Ikenaga M, Ohura K, Kotoura Y, Yamamuro T, Nakamura T, Oka M, Hiraoka M, Abe M

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan.

出版信息

Int J Hyperthermia. 1994 Jul-Aug;10(4):507-16. doi: 10.3109/02656739409009354.

Abstract

Although the incidence of metastatic bone tumours is recently increasing, the local control rate of conventional treatment modalities is not satisfactory. If an intramedullary nail for the fixation of a weakened bone with metastatic lesions can be used as a heat-generating material for hyperthermia, the treatment result is expected to improve. This new approach to hyperthermic treatment of bone tumours has been investigated in a canine tibia. An intramedullary nail made of stainless steel was put into a medullary canal of a canine tibia. The leg was exposed to an alternating magnetic field of 100 kHz in the frequency and 100 Oe in the maximum intensity. The nail was inductively heated for 60 min. The temperature of the nail > 50 degrees C and the cancellous bone 5 mm from the nail was heated to a therapeutic temperature, 42.5 degrees C. After a bone labelling with tetracycline and calcein, the dogs were killed 2, 4 and 12 weeks after the heating. The area of osteonecrosis was evaluated by fluorescence microscopy analysis. The heated cancellous bone around the nail showed osteonecrosis in 2 weeks after the treatment, but it recovered completely in 12 weeks. This experiment has demonstrated the heating capability of the new hyperthermic technique and minimal toxicity to the bone, and suggests the clinical application to metastatic bone tumours.

摘要

尽管转移性骨肿瘤的发病率近来呈上升趋势,但传统治疗方式的局部控制率并不令人满意。如果用于固定有转移病变的脆弱骨骼的髓内钉能够用作热疗的发热材料,那么治疗效果有望得到改善。这种骨肿瘤热疗的新方法已在犬胫骨上进行了研究。将一根不锈钢制成的髓内钉置入犬胫骨的髓腔。使腿部暴露于频率为100kHz、最大强度为100奥斯特的交变磁场中。髓内钉感应加热60分钟。髓内钉温度>50℃,距髓内钉5mm的松质骨被加热至治疗温度42.5℃。在用四环素和钙黄绿素进行骨标记后,在加热后2周、4周和12周处死犬。通过荧光显微镜分析评估骨坏死面积。治疗后2周,髓内钉周围加热的松质骨出现骨坏死,但在12周时完全恢复。该实验证明了这种新热疗技术的加热能力以及对骨骼的最小毒性,并提示了其在转移性骨肿瘤临床应用的可能性。

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