Waterman F M, Komarnicky L, Leeper D B
Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA.
Int J Hyperthermia. 1998 Sep-Oct;14(5):421-34. doi: 10.3109/02656739809018245.
The response of human tumour blood flow to a fractionated course of thermoradiotherapy was documented in four superficial but bulky tumours (three adenocarcinomas, one melanoma). Blood flow was measured 15, 30, 45, and 60 min after the onset of heating. These measurements were made at the same intra-tumour point during each heat fraction by use of a modified thermal clearance technique in which a correction was made for the heat dissipated by thermal conduction. This point was at least 2 cm beneath the surface in the central portion of the tumour. Extracellular pH was measured within 1 cm of this point prior to the first heat fraction and 2-3 weeks later. Hyperthermia was administered for 60 min, twice a week for 4 weeks by use of a 16-channel 915 MHz microwave applicator. Each patient also received a radiation dose of 40 Gy fractionated at 2 Gy/fx, five times a week (adenocarcinomas) or 4 Gy/fx, twice a week (melanoma). Blood flow remained relatively constant during heating after steady state conditions were attained. However, an overall decrease in tumour blood flow was observed in each patient over the course of thermoradiotherapy. In each case, a relatively small decrease in blood flow occurred between most heat fractions which resulted in an overall decrease which ranged from 50-100%. However, there was a tendency for blood flow to increase following the initial heat fraction at points where the steady state temperature was approximately 41 degrees C or less. Extracellular pH increased in two of three patients and decreased in the other.
记录了4例浅表但体积较大的肿瘤（3例腺癌，1例黑色素瘤）对热放疗分次疗程的人体肿瘤血流反应。在加热开始后15、30、45和60分钟测量血流。在每个热分次期间，通过使用改良的热清除技术在肿瘤内的同一点进行这些测量，其中对热传导耗散的热量进行了校正。该点位于肿瘤中心部分距表面至少2厘米处。在第一次热分次之前和2-3周后，在该点1厘米范围内测量细胞外pH。使用16通道915 MHz微波施加器进行60分钟的热疗，每周两次，共4周。在达到稳态条件后，加热期间血流保持相对恒定。然而，在热放疗过程中，观察到每位患者的肿瘤血流总体下降。在每种情况下，大多数热分次之间血流出现相对较小的下降，导致总体下降幅度在50%-100%之间。然而，在稳态温度约为41℃或更低的点，初始热分次后血流有增加的趋势。3例患者中有2例细胞外pH升高，另1例降低。
