Vanselow B, Dietz A, Rudat V, Wollensack P, Bettscheider C, Eble M J
Hals-, Nasen-, Ohrenklinik, Universität Heidelberg.
HNO. 1997 Mar;45(3):140-6. doi: 10.1007/s001060050103.
The therapeutic effect of radiotherapy depends amongst other things on the degree of oxygenation of tumour tissue. Epithelial carcinomas of the head-neck region exhibit considerable hypoxic areas which vary markedly between individuals and not encompassed by current staging and grading. It is assumed that during radiation treatment a reoxygenation of hypoxic tumour cells takes place. It was investigated wether the occurrence of reoxygenation could be determined by invasive oxygen partial pressure measurements in lymph node metastases. Using a needle probe inserted transcutaneously into a lymph node polarographic oxygen determinations (Eppendorf pO2-Histiograph) were made on 13 patients with advanced oro- and hypopharyngeal carcinomas before therapy and after a week of accelerated radio- or radiochemotherapy. Low pO2 values before treatment (median 13.5 mmHg, average 20.3 mmHg) and a hypoxic fraction (pO2 < 10 mmHg) of 45.2% indicated manifest tumour hypoxia. After the first week of treatment a significant increase in the median- (24.1 mmHg) and the average pO2 (28.2 mmHg) as well as a reduction in the hypoxic fraction (27%) were observed. Invasive pO2 histiography fulfils the requirements for a method to confirm tumour hypoxia in head-neck tumours. The results obtained indicate that reoxygenation occurs during the initial phases of radio- and radio-chemotherapy.
放射治疗的疗效尤其取决于肿瘤组织的氧合程度。头颈部上皮癌存在相当大的缺氧区域，这些区域在个体之间差异显著，且目前的分期和分级并未涵盖。据推测，在放射治疗期间，缺氧肿瘤细胞会发生再氧合。研究了是否可以通过对淋巴结转移灶进行有创氧分压测量来确定再氧合的发生情况。使用经皮插入淋巴结的针式探头，对13例晚期口咽和下咽癌患者在治疗前以及加速放疗或放化疗一周后进行极谱法氧测定（Eppendorf pO2组织氧测定仪）。治疗前低氧分压值（中位数13.5 mmHg，平均值20.3 mmHg）和45.2%的缺氧分数（氧分压<10 mmHg）表明存在明显的肿瘤缺氧。治疗第一周后，观察到中位数（24.1 mmHg）和平均氧分压（28.2 mmHg）显著升高，以及缺氧分数降低（27%）。有创氧分压组织氧测定法满足了确认头颈部肿瘤缺氧的方法要求。所得结果表明，再氧合发生在放疗和放化疗的初始阶段。
