Kanser tedavisinde klinik hipertermi
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Date
1993-04-19
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Uludağ Üniversitesi
Abstract
Radyasyon tedavisine adjuvan olarak hipertermi kanser tedavisinde giderek önem kazanmaktadır. Hiperterminin halen en önemli etkisi lokorejyonel kontrol üzerindedir. Isı, tümör hücrelerine direkt olarak sitotoksik olabildiği gibi, radyasyon tedavisi sonucunda oluşan subletal ve öldürücü potansiyele sahip sarın tamirini de engellemektedir. Bu etkiler tümörde asidoz ve hipoksiye yol açan fizyolojik etmenler tarafindan arttırılmaktadır.Tümördeki kan dalımının normal dokuya göre zaten bozulmuşken hipertermi kan dolaşımında daha da azalma oluşturmak ta, bu da ısıya duyarlılığı güçlendirmektedir. ÖzelIikle 3 alanda termo radyoterapi (TR) üzerine çalışmalar yoğunlaşmıştır. Bunlar rekürran yada primer meme kanserleri, melanoma ve baş boyun kanserleri dir. Bu tümörlerde çok başarılı sonuçlar bildirilmektedir. Genel olarak tam cevap (CR) için en önemli prognostik faktörler olarak radyasyon dozu. Tümör büyüklüğü ve minimal termal parametre/er bildirilmektedir. Haftada verilen hipertermi sayısının. muhtemelen term tolerans bir göstergesi olarak tümör cevabı üzerine etkisi gösterilmiştir Lokal kontrol süresi için de en önemli prognostik faktörler tümör histolojisi, radyasyon dozu, tümör derinliği ve minimal tümör içi ısı idi.
Hyperthermia as an adjunct to radiation therapy has been a focus of interest in cancer management. The major impact of hyperthermia is currently on loco-regional control of tumor. Heat may be direct Iy cytotoxic to tumor cells or inhibit repair of both sublethal and potentially lethal damage after radiation. These effects are augmented by the physiological conditions in turnar which lead to states of acidosis and hypoxia. Blood flow is often impaired in tumors relative to normal tissue, and hype tf-qrmia may lead to a further decrease in blood flow and augment heat-sensitivity. Three major areas of clinical or estigation have borne the greatest fruit for hyperthermia as adjunctive therapy to radiat:on therapy. These include recurrent and primary eası lesions, melanoma, and head ınd neck neoplasms. In general, the most important prognostic factors for complete response are radiation dose, tumor size and minimal thermal parameters. The number of heat fractions administered per week appears to have no bearing on the overall response, which may be indicative of the effects of thermotolerance. The major prognostic factors for the duralian of local control were turnah histology, concurrent radiation dose, turnar depth and
Hyperthermia as an adjunct to radiation therapy has been a focus of interest in cancer management. The major impact of hyperthermia is currently on loco-regional control of tumor. Heat may be direct Iy cytotoxic to tumor cells or inhibit repair of both sublethal and potentially lethal damage after radiation. These effects are augmented by the physiological conditions in turnar which lead to states of acidosis and hypoxia. Blood flow is often impaired in tumors relative to normal tissue, and hype tf-qrmia may lead to a further decrease in blood flow and augment heat-sensitivity. Three major areas of clinical or estigation have borne the greatest fruit for hyperthermia as adjunctive therapy to radiat:on therapy. These include recurrent and primary eası lesions, melanoma, and head ınd neck neoplasms. In general, the most important prognostic factors for complete response are radiation dose, tumor size and minimal thermal parameters. The number of heat fractions administered per week appears to have no bearing on the overall response, which may be indicative of the effects of thermotolerance. The major prognostic factors for the duralian of local control were turnah histology, concurrent radiation dose, turnar depth and
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Keywords
Hipertermi, Radyoterapi, Kanser, Tedavi, Onkoloji, Hyperthermia, Radiotherapy, Cancer, Treatment, Oncology
Citation
Engin, K. (1993). ''Kanser tedavisinde klinik hipertermi''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 20(3), 325-329.