von Ardenne M
Von Ardenne Institute of Applied Medical Research, Dresden.
Strahlenther Onkol. 1994 Oct;170(10):581-9.
PURPOSE: The so-called Cancer Multistep Therapy was conceived by the author in 1965. It is a combined modality treatment with 3 process steps: whole-body hyperthermia (WBH), hyperglycemia (HG) and hyperoxemia (HO). The original therapy concept was further developed into a systemic Cancer Multistep Therapy (sCMT) of high efficiency and selectivity. An outline follows of this therapy and the actual state of the sCMT concept as per 1993 (new in timing, dosage, technique). Knowledge of the synergetic-additive efficiency of various groups of cytostatics reacting to the effects of the main treatment process steps (WBH + HG + HO) led in 1974 to an extension of the sCMT concept by including chemotherapy. In addition, a radiotherapeutical treatment was included in this concept as cancer cells clearly show a higher sensibility to radiation while under the influence of sCMT. METHOD: Before commencement of whole-body hyperthermia, the blood glucose concentration is increased to approximately 27 mM in order to lower the pH values in the cancer tissues. Afterwards, the whole-body hyperthermia climaxes with a 60 ... 90 min plateau period of approximately 42 degrees C. This is achieved by means of a specially developed infrared-A irradiation machine named IRATHERM 2000. Parallel to the hyperthermia treatment, the patient inhales air enriched with oxygen at a flow rate of up to 30 l/min, which heightens the stress tolerability. Following the sCMT treatment, the patient remains under observation on an intensive in-patient basis for 24 hours before he or she is discharged for out-patient post-treatment care. During the main treatment, the body-core and skin temperatures as well as the heart and circulatory system of the patient are constantly monitored and he is subjected to a close-meshed surveillance of his glucose, lactate concentration, blood-gas, electrolyte, water and acid base values. On completion of the therapy treatment, the patient takes part in a standardised long-term dispensary programme. About 1 week before and 1 week after the main treatment day the weakened state of the patient necessitates his participation in an Oxygen Multistep Therapy with immunostimulation. RESULTS: The systemic tolerance of sCMT with minimal side-effects has been proven with several 100 patients and results have been published as part of the phase-I study [36]. A first evaluation of the efficacy of sCMT was documented in the same study. CONCLUSION: The systemic tolerability effects of sCMT on the one hand and the positive therapeutic influence on the course of the illness on the other hand, have encouraged us to carry out more research on the efficacy of sCMT, and this will be published shortly.
目的:所谓的癌症多步骤疗法由作者于1965年提出。它是一种包含三个过程步骤的联合治疗方法:全身热疗(WBH)、高血糖(HG)和高氧血症(HO)。最初的治疗理念进一步发展为高效且具有选择性的系统性癌症多步骤疗法(sCMT)。以下是该疗法的概述以及截至1993年sCMT概念的实际情况(在时间、剂量、技术方面均为新内容)。1974年,由于了解到各类细胞抑制剂对主要治疗过程步骤(WBH + HG + HO)的协同增效作用,sCMT概念得以扩展,纳入了化疗。此外,该概念还纳入了放射治疗,因为癌细胞在sCMT的影响下对辐射表现出更高的敏感性。 方法:在开始全身热疗之前,将血糖浓度提高至约27 mM,以降低癌组织中的pH值。之后,全身热疗在约42摄氏度的60至90分钟平台期达到高潮。这通过一台专门研发的名为IRATHERM 2000的红外A辐射机来实现。在热疗过程中,患者以高达30升/分钟的流速吸入富含氧气的空气,这提高了应激耐受性。在接受sCMT治疗后,患者在重症住院观察24小时,然后出院接受门诊后续治疗。在主要治疗期间,持续监测患者的体核温度、皮肤温度以及心脏和循环系统,并对其血糖、乳酸浓度、血气、电解质、水和酸碱值进行密切监测。治疗结束后,患者参与标准化的长期门诊治疗方案。在主要治疗日之前约1周和之后约1周,患者因身体虚弱需要参与免疫刺激的氧多步骤疗法。 结果:数百名患者已证明sCMT具有最小副作用的全身耐受性,相关结果已作为I期研究的一部分发表[36]。同一研究记录了对sCMT疗效的首次评估。 结论:一方面,sCMT的全身耐受性效果,另一方面,其对病程的积极治疗影响,促使我们对sCMT的疗效开展更多研究,相关研究结果将很快发表。
Intensive Care Med. 1999-9
Med Radiol (Mosk). 1987-1
Radiol Clin North Am. 1989-5