联合热疗提高复发直肠癌患者免疫功能和放疗疗效

目的:探讨三维适形放疗联合盆腔热疗的疗效,安全性,以及对患者免疫功能的影响.方法:46例复发直肠癌患者按收治的时间顺序交替分为两组.A组三维适形放疗联合盆腔热疗组,B组为单纯三维适形放射治疗组,比较两组的疗效、不良反应和免疫功能.结果:A组中位局部无进展生存期较B组显著延长(16.3 mo vs 14.1 mo,P<0.05);对患者外周血T淋巴细胞亚群分析表明:A组治疗后CD3+、CD4+水平以及CD4+/CD8+比值较治疗前显著增加(CD3+:65.40%±6.18%vs 56.90%±6.16%;CD4+:32.70%±6.37%vs 28.30%±6.33%;CD4+/CD8+比值:1.24±0.23 vs 0.96±0.28,均P<0.05).B组上述指标变化无统计学差异;不良反应主要为直肠急性放射性反应,均可耐受;两组患者局部症状缓解率、1年生存率、2年生存率比较无显著差异.结论:三维适形放疗联合盆腔热疗与单纯三维适形放射治疗相比可延长患者中位局部无进展生存期,耐受性好,可明显提高患者免疫功能.

不同方式加热联合甲基莲心碱对耐药乳腺癌MCF-7/Adr细胞γH2AX及mdr-1/P-gp表达的影响

目的:检测不同模式加热联合甲基莲心碱(neferine,Nef)对耐药乳腺癌MCF-7/Adr细胞的增殖抑制及γH2AX和mdr-1/P-gp表达的影响。方法:采用MTT法检测金属模块加热、培养基加热、烤箱加热及水浴加热等不同模式加热联合10μg/mL Nef对经阿霉素培养的MCF-7/Adr细胞的增殖抑制,实时定量PCR检测mdr-1mRNA的表达,Western印迹法检测γH2AX及P糖蛋白(P-glycoprotein,P-gp)的表达。结果:42℃及45℃不同模式加热组较37℃培养组MCF-7/Adr细胞吸光度值明显下降,mdr-1/P-gp表达下降,γH2AX表达上调(均P<0.01)。加热联合10μg/mLNef组较单纯热疗组及单纯10μg/mLNef组MCF-7/Adr细胞吸光度值明显下降(均P<0.01),mdr-1/P-gp表达下降,γH2AX表达上调(均P<0.05)。42℃及45℃不同模式加热组比较,水浴加热组P-gp表达下降及γH2AX表达上调最为明显(P<0.05)。结论:加热能增加阿霉素对MCF-7/Adr细胞的细胞毒性反应,能明显增加MCF-7/Adr细胞DNA损伤且随温度升高而加剧;MCF-7/Adr细胞对不同模式的加热反应可能不同;热疗联合Nef能增敏阿霉素的化学治疗效果。

超声体模及性能测试

用水、明胶、油及n-丙醇等材料制成的一种超声体模,具有与人体软组织相似的超声特性,包括声速、密度、衰减系数和散射。并利用本所新研制的多元阵列超声治癌热疗系统对体模的温升性能进行了测试,其结果与活体动物组织的实验结果相接近。

Controlled Local Hyperthermia and Magnetic Hyperthermia of Surface (Skin) Cancer Diseases

Average size of hematite and magnetite micro and nanopowders and polydispersity index, zeta potential and distribution of particles were studied. Analysis showed that average size of the obtained particles for magnetite is 740.9 nm, for hematite particles 30 - 35 nm. Alternate current feed source was created for hyperthermia. Proceeding from the requirements of the objectives, the U type MnZn material magneto conductors were selected, in which 10.0 and 8.0 mm width gaps were cut and glass test tubes with magnetite or hematite suspensions were placed in them. Series of experiments at various field intensity and frequencies showed that for efficient magnetic hyperthermia therapy more powerful device was needed with frequency of up to 10 Mega Hertz to achieve the temperature 43°C - 45°C necessary for full activation of Neel and Brown mechanisms in particles. At the next stage, on the basis of experimental material the anticancer mono-therapeutic effect of hyperthermia and its adjuvant action in poly chemotherapeutic treatment was presented by the use of a device created by us “Lezi”. As a result of the experiment it was shown that in all animals (outbred albino mice, 3 months old) inhibition of cancer growth was fixed and intratumoral necrosis was developed, while after 7 and 10 sessions tumors were ulcerated, which refers to positive effect of the experiment (Conclusion of Pathologicanatomical Laboratory “PATGEO”, Tbilisi, Georgia ).

Fe@CN-CN对大鼠移植性肝癌磁靶向热疗效果的观察

目的:研究碳包铁纳米笼壳聚糖微球(Fe@CN-CN)在交变磁场中感应产热规律,观察其对大鼠移植性肝癌(HCC)的磁靶向热疗效果。方法:在体外,观察Fe@CN-CN在高频交变磁场中感应产热规律,确定体内实验条件。36只移植性HCC大鼠随机分为3组(n=12),A组生理盐水组,B组微球组,C组微球热疗组。C组治疗中记录肿瘤区及周围器官温度,7d后,测量肿瘤体积、质量,计算瘤质量抑制率,病理切片观察肿瘤病理变化和微球沉积情况,比较各组治疗效果。结果:不同浓度、不同电流强度条件下磁流体均能在20min内达到最高温度,产热效应随着两者升高而增强。肿瘤区组织温度10min内可达到(42.6±0.20)℃,可恒温维持30min,并显著性高于右肝叶和直肠温度(F=10.925,P=0.000)。C组的瘤质量显著小于其他两组(F=98.830,P=0.000)。C组的瘤质量抑制率为48.5%,是B组的1.5倍;C组的肿瘤体积最小,显著小于其他两组(F=89.086,P=0.000),仅是A组的42.5%;病理切片显示C组和B组肿瘤组织中均见Fe@CN-CN沉积,C组肿瘤组织呈重度坏死,B组呈中度坏死,A组呈轻度坏死。结论:Fe@CN-CN具有良好的感应产热性能,能靶向定位于大鼠移植性HCC,在交变磁场作用下能有效升高肿瘤组织温度,从而产生显著的治疗效果。

Mathematical and numerical analysis of thermal distribution in cancerous tissues under the local heat therapy

The main purpose of this study is to investigate the thermal behavior of living tissues in the presence of spatial external heat source. An effort has been made to formulate the mathematical model to study the temperature distribution in in vivo tissues of the human body. The mathematical formulation is governed by bio-heat equation together with appropriate initial, boundary and interface conditions. The solution of the model was carried out using variational finite element method and computational simulations. The model describes the exchange of heat between the internal biological tissues and other surrounding media. The effect of external heat source under different conditions of atmospheric temperature and as a local hyperthermic method provides an impor- tant information to the temperature regulation in biological tissues under normal and malignant conditions. Thermal fluctuations at the targeted regions were obtained with respect to various time-dependent heating sources and scattering coefficients. The results obtained may be helpful for clinical purposes especially in the treatment of cancerous tumors through radiotherapy and other local hyperthermic approaches.

超顺磁纳米Fe_3O_4磁性流体的制备及其在交变磁场中的发热性能

采用两步法以油酸为表面活性剂对纳米Fe_3O_4磁性粒子进行表面修饰,制备出稳定的Fe_3O_4油基磁性流体。通过透射电镜(TEM)、X射线衍射仪(XRD)、红外光谱(FT-IR)、振动样品磁强计(VSM)对油酸修饰后的纳米Fe_3O_4磁性粒子的形貌、结构与磁性能进行了表征。结果表明,在表面活性剂存在时,可以有效地减少纳米Fe_3O_4磁性粒子之间的团聚,同时使油基磁性流体具有良好的稳定性和发热性;纳米Fe_3O_4磁性粒子的饱和磁化强度为66.35 A·m2/kg,剩余磁化强度为0,具有超顺磁性;在外加交变磁场下,纳米Fe_3O_4油基磁性流体在20 min时,发热温度可达55.9℃。

新辅助化疗联合肿瘤细胞减灭术后热灌注化疗治疗晚期卵巢癌疗效观察

目的探讨新辅助化疗联合肿瘤细胞减灭术后热灌注治疗晚期卵巢癌的临床疗效。方法选取2009年4月至2012年7月间收治的60例晚期卵巢癌患者,按收治时间顺序分为两组,观察组患者术前采取新辅助化疗,术后联合腹腔内热灌注辅助化疗1次(顺铂80mg),术后给予TC/TP方案化疗;对照组患者采取常规肿瘤细胞减灭术+术后TC/TP方案化疗,比较两组患者在手术时间、出血量、腹水量、术后化疗疗程、疗效、复发与死亡、生存率等方面的差异。结果观察组患者手术时间为(215.34±32.76)min,腹水量为(678.35±32.32)ml,失血量为(502.89±118.53)ml,对照组患者手术时间为(275.35±42.98)min,腹水量为(1242.24±204.3)ml,失血量为(759.64±153.45)ml,两组比较差异有统计学意义(P<0.05)。观察组患者术后化疗疗程较对照组明显减少(P<0.05)。观察组患者总有效率为83.3%,对照组为33.3%,两组比较差异有统计学意义(P<0.05)。观察组和对照组患者1年生存率比较,差异有统计学意义(P<0.05)。结论晚期卵巢癌患者采取术前新辅助化疗联合肿瘤细胞减灭术、术后热灌注辅助化疗,对患者预后和疗效较常规的方法有较大提高,值得在临床上进行推广。