Content uploaded by Muhammad Idrees
Author content
All content in this area was uploaded by Muhammad Idrees on Jun 18, 2015
Content may be subject to copyright.
A preview of the PDF is not available
A REVIEW ON POTENTIAL BENEFITS OF HYPERTHERMIA IN THE TREATMENT OF CANCER
Abstract and Figures
Hyperthermia treatment is exposing the body to supra normal temperature which is
elevated to kill the cancerous cells without damaging the healthy tissues. Hyperthermia is a
cancer treatment technique in which the temperature of the affected part of the body is
slightly raised (41.5 to 430C / 104 -113 0F) to damage and kill cancer cells or to make
cancer cells more susceptible to radiotherapy or chemotherapy. Hyperthermia could be
considered as the forth pillar for the treatment of cancer in addition to radiotherapy,
chemotherapy and surgery. Treatment strategy involving hyperthermia combined with
radiotherapy/ biotherapy/ chemotherapy/ surgical intervention results in higher response
rates, improved tumor control, better palliative effects and better overall survival rates.
Figures - uploaded by Muhammad Idrees
Author content
All figure content in this area was uploaded by Muhammad Idrees
Content may be subject to copyright.
... In clinical applications, heat is typically generated by applying an alternating magnetic field to the magnetic materials that were previously implanted or injected into the tumor site in order to increase and maintain the local temperature slightly above 40 • C, which our GCFe glass-ceramics were able to show good performance (Fig. 2c). Malignant cells are then selectively killed as heat is slowly dissipated in cancerous tissues due to the lack of a wellorganized vascular network [50]. ...
Although the three main phases of iron oxide-hematite, maghemite, and magnetite-exhibit superparamagnetic properties at the nanoscale, only maghemite and magnetite phases have been explored in magnetic bioactive glass-ceramics aimed at applications in cancer treatment by hyperthermia. In this work, it is reported for the first time the superparamagnetic properties of hematite nanocrystals grown in a 58S bioactive glass matrix derived from sol-gel synthesis. The glass-ceramics are based on the (100-x)(58SiO 2-33CaO-9P 2 O 5)-xFe 2 O 3 system (x = 10, 20 and 30 wt%). A thermal treatment leads to the growth of hematite (α-Fe 2 O 3) nanocrystals, conferring superparamagnetic properties to the glass-ceramics, which is enough to produce heat under an external alternating magnetic field. Besides, the crystallization does not inhibit materials bioactivity, evidenced by the formation of calcium phosphate onto the glass-ceramic surface upon soaking in simulated body fluid. Moreover, their cytotoxicity is similar to other magnetic bioactive glass-ceramics reported in the literature. Finally, these results suggest that hematite nanocrystals' superparamagnetic properties may be explored in multifunctional glass-ceramics applied in bone cancer treatment by hyperthermia allied to bone regeneration.
... When hyperthermia takes place at 43 C, it stimulates T cell activity and response by changing the ratio of CD 4 /CD 8 cells and upregulation of IL-2 production from lymphocyte, which leads to immune-stimulatory action and thereby enhances the necrosis of tumor cells as depicted in Fig. 11.2 Valentina et al., 2005). In addition to the mentioned effects of hyperthermia on tumor cells metabolism and functions, it also worsens the tumor microenvironment by making a group of biochemical and microcirculatory changes such as acidosis, RBC stiffening and aggregation, increased vascular permeability, platelet aggregation, and intravascular clotting as discussed in the previous section (Idrees and Jebakumar, 2014). ...
Hyperthermia, sometimes known as thermotherapy or thermal ablation, is a new emerging therapeutic technique that depends on heating the target cells or tissues up to sufficient temperature to destroy them without affecting nearby cells. Hyperthermia is considered as one of the promising treatment regimens for cancer, which works via mechanism believed to be through the damage of microtubules. Many techniques and methods of hyperthermia have been utilized in cancer, especially the superficial, whole body, indocavity, deep and partial body hyperthermia. In addition to being an alternative to the conventional thermal ablation and chemotherapy for cancer treatment, hyperthermia is considered as one of the choices for the treatment of arthritis, wounds, and pain. Research interest on hyperthermia as a treatment procedure is growing from day to day, as a result of which various new possible therapeutic applications are emerging such as heat-controlled gene therapy, heat-enhanced immunotherapy, and vaccination, because these applications depend on the fact that heat interferes with the regulation of cell cycle, DNA repair, and cell apoptosis. Although many materials have been utilized as hyperthermia agents, biomaterials are being considered as an excellent choice due to their significant thermal conductivity, high photothermal conversion efficacy, and many other attractive properties. On the other hand, adequate accumulation of nanoparticles inside tumor cells has also been linked with a successful hyperthermia therapy. This chapter extensively discusses hyperthermia as a treatment strategy, covering various types and techniques of hyperthermia, the possible applications to tackle cancer and the concomitant use of biomaterials and nanoparticles for hyperthermia.
... Treatment of bone cancer by magnetic hyperthermia involves the use of implantable materials to generate heat in the diseased site under the application of an external alternating magnetic field [41]. Malignant cells are selectively killed if exposed to temperatures within 41-47°C due to their intrinsic microenvironment including low pH, whereas normal cells can survive at even higher temperatures [42]. Tumors are prone to be more efficiently heated compared to surrounding healthy tissues as their vascular network is poorly structured and cannot dissipate heat efficiently. ...
Implementing novel approaches for cancer therapy are under continuous progress, and bioactive glasses (BGs)and glass-ceramics show excellent potential in this regard. Although these materials have been mostly used as magnetic substances in hyperthermia approach, some of their subsets, i.e., mesoporous bioactive glasses (MBGs), have been recently proposed not only as magnetic materials but also as drug delivery systems for advanced treatment of bone cancer. Different types of MBGs including granular particles and three-dimensional (3D)scaffolds can be applied for cancer therapy. Based on the results obtained from in vitro studies, MBGs seem to have a bright future in the therapeutic strategies to combat cancer; however, their application in this field is still in its beginning, and more research needs to reveal all pros and cons of this newly proposed approach.
... Materials 2018, 11, 173 2 of 15 of a well-organized vascular network; moreover, hyperthermia causes many changes in cells and leads to a loss of cellular homeostasis [11]. ...
This work deals with the synthesis and characterization of novel Fe-containing sol-gel materials obtained by modifying the composition of a binary SiO₂-CaO parent glass with the addition of Fe₂O₃. The effect of different processing conditions (calcination in air vs. argon flowing) on the formation of magnetic crystalline phases was investigated. The produced materials were analyzed from thermal (hot-stage microscopy, differential thermal analysis, and differential thermal calorimetry) and microstructural (X-ray diffraction) viewpoints to assess both the behavior upon heating and the development of crystalline phases. N₂ adsorption-desorption measurements allowed determining that these materials have high surface area (40-120 m²/g) and mesoporous texture with mesopore size in the range of 18 to 30 nm. It was assessed that the magnetic properties can actually be tailored by controlling the Fe content and the environmental conditions (oxidant vs. inert atmosphere) during calcination. The glasses and glass-ceramics developed in this work show promise for applications in bone tissue healing which require the use of biocompatible magnetic implants able to elicit therapeutic actions, such as hyperthermia for bone cancer treatment.
... The absorption of light by the nanoshells creates an intense heat burning away the tumor, while healthy cells nearby remain unharmed. This killing effect of heat is also know as Hyperthermia [17]. Advantage: zero toxic effects (unlike chemotherapy) no ionizing radiation (like radiotherapy). ...
The interface between nanosystems and biosystems is emerging as one of the broadest and most dynamic areas of science and technology, bringing together biology, chemistry, physics and many areas of engineering, biotechnology and medicine. Any damage at molecular or cellular level is the major culprit for disease & ill health. Nanotechnology, “the manufacturing technology of the 21st century," helps us to build a broad range of complex molecular machines by manipulating matter on an atomic and molecular scale. Nanotechnology is the creation of useful materials, devices and system through the manipulation of matter on an atomic, molecular, and supra-molecular level in the length scale of 1-100 nanometer size. At the nano scale, the physical, chemical, and biological properties of materials differ in fundamental and valuable ways from the properties of individual atoms and molecules or bulk matter .It enables the alignment of atoms in the most effective way in a very limited place. Extraordinary devices can be created by using this technique. Molecules could be aligned in such a way as to produce desired result in the areas of strength, ductility, reactivity, conductivity and capacity. This idea facilitates creating devices and structures that would occupy an unimaginably small space and have novel properties and functions because of their small size. The application of nanotechnology in the medical sector is referred as Nanomedicine. Nanoparticles have potential applications in the field of medical sciences including new diagnostic tools, imaging agents and methods, targeted drug delivery, pharmaceuticals, bio implants and tissue engineering. Drugs with high toxic potential like cancer chemotherapeutic drugs can be given with better safety profile with the utility of nanotechnology. The aim of the nanotechnology in the medical sciences is to develop new materials and methods to detect and treat diseases in a targeted, precise, effective and lasting way, with the ultimate goal of making medical practice safer and less intrusive.
Copper-containing ferrimagnetic glass-ceramic with the following composition: 24.7% SiO2-8.5% CaO-13.5% Na2O-3.3% P2O5-31% Fe2O3-14% FeO–5CuO (wt%) was synthesized by means melt and quenching process both in powder and bulk form. The obtained samples were characterized and compared by means morphological, compositional and structural analyses. The magnetic properties and the ability to release heat were also investigated together with the antimicrobial properties towards S. aureus strain. The obtained results showed that copper introduction and the annealing process influenced the nucleation of crystalline phases; in particular the samples produced in powder form evidenced a low amount of magnetite and thus a reduced hysteresis area and ability to produce heat when exposed to an alternating magnetic field. While Cu-containing samples in the bulk form maintained the magnetic and calorimetric properties of pristine glass-ceramic. Preliminary evaluation of antibacterial properties demonstrated Cu-doped samples were not able to reduce the bacterial proliferation and thus the need to optimize the copper introduction process.
The response of the vascular net of hepatomas and other rat tumors to epinephrine, acetyl-ß-methylcholine, cold, and ganglionectomy has been studied in ovarian and renal “tissue-isolated” transplants. With this technique the vascular response of the tumor can be separated from the response of the vascular net of the host. Under the action of the stimuli tested, the vessels of a tumor behaved like the vessels of the host organs, even when the tumor was 200-fold larger, and no residue of the host-tissue was demonstrable in the histologic sections. Acetyl-β-methyl-choline produced an increase of blood flow in tumors, the other stimuli produced a drop in the blood supply. The transformation of the vascular tree of the host into the vascular tree of the tumor was followed by the preparation of vinylite casts of the blood vessels. By this technique it was possible to demonstrate that the main vascular branches which supply the host organ became the main vascular branches which supply the tumor. These vessels do not increase in number but greatly increase in length and diameter. The vessels of a regenerating liver behaved in the same manner.
Learning Objectives
After completing this course, the reader will be able to:Discuss the prognostic significance of intratumoral hypoxia and low hemoglobin levels in patients receiving curative-intent radiation for head and neck or cervical cancer.Describe the potential relationship between anemia and intratumoral hypoxia in patients with solid tumors.List possible interventions for improving intratumoral oxygenation and radiosensitivity in the radiation oncology setting.
Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com
Local recurrence remains a major obstacle to achieving cure of many locally advanced solid tumors treated with definitive radiation therapy. The microenvironment of solid tumors is hypoxic compared with normal tissue, and this hypoxia is associated with decreased radiosensitivity. Recent preclinical data also suggest that intratumoral hypoxia, particularly in conjunction with an acid microenvironment, may be directly or indirectly mutagenic. Investigations of the prognostic significance of the pretreatment oxygenation status of tumors in patients with head and neck or cervical cancer have demonstrated that increased hypoxia, typically designated in these studies as pO2 levels below 2.5-10 mm Hg, is associated with decreased local tumor control and lower rates of disease-free and overall survival. Hypoxia-directed therapies in the radiation oncology setting include treatment using hyperbaric oxygen, fluosol infusion, carbogen breathing, and electron-affinic and hypoxic-cell sensitizers. These interventions have shown the potential to increase the effectiveness of curative-intent radiation therapy, demonstrating that the strategy of overcoming hypoxia may be a viable and important approach. Anemia is common in the cancer population and is suspected to contribute to intratumoral hypoxia. A review of the literature reveals that a low hemoglobin level before or during radiation therapy is an important risk factor for poor locoregional disease control and survival, implying that a strong correlation could exist between anemia and hypoxia (ultimately predicting for a poor outcome). While having a low hemoglobin level has been shown to be detrimental, it is unclear as to exactly what the threshold for “low” should be (studies in this area have used thresholds ranging from 9-14.5 g/dl). Optimal hemoglobin and pO2 thresholds for improving outcomes may vary across and within tumor types, and this is an area that clearly requires further evaluation. Nonetheless, the correction of anemia may be a worthwhile strategy for radiation oncologists to improve local control and survival.
Purpose:
Claims for the value of hyperthermia as an adjunct to radiotherapy in the treatment of cancer have mostly been based on small Phase I or II trials. To test the benefit of this form of treatment, randomized Phase III trials were needed.
Methods and materials:
Five randomized trials addressing this question were started between 1988 and 1991. In these trials, patients were eligible if they had advanced primary or recurrent breast cancer, and local radiotherapy was indicated in preference to surgery. In addition, heating of the lesions and treatment with a prescribed (re)irradiation schedule had to be feasible and informed consent was obtained. The primary endpoint of all trials was local complete response. Slow recruitment led to a decision to collaborate and combine the trial results in one analysis, and report them simultaneously in one publication. Interim analyses were carried out and the trials were closed to recruitment when a previously agreed statistically significant difference in complete response rate was observed in the two larger trials.
Results:
We report on pretreatment characteristics, the treatments received, the local response observed, duration of response, time to local failure, distant progression and survival, and treatment toxicity of the 306 patients randomized. The overall CR rate for RT alone was 41% and for the combined treatment arm was 59%, giving, after stratification by trial, an odds ratio of 2.3. Not all trials demonstrated an advantage for the combined treatment, although the 95% confidence intervals of the different trials all contain the pooled odds ratio. The greatest effect was observed in patients with recurrent lesions in previously irradiated areas, where further irradiation was limited to low doses.
Conclusion:
The combined result of the five trials has demonstrated the efficacy of hyperthermia as an adjunct to radiotherapy for treatment of recurrent breast cancer. The implication of these encouraging results is that hyperthermia appears to have an important role in the clinical management of this disease, and there should be no doubt that further studies of the use of hyperthermia are warranted.
Tumor blood flow, measured by an isotope dilution technique, is only 2% to 15% of that of the surrounding tissue. This sluggish circulation differentiates cancer from normal tissue and forms the basis for a new therapy that entails the transfer of radiofrequency (RF) energy for heating tissues locally. The heated tissue is cooled by the circulation of blood, which carries away the heat. Impaired perfusion, as in cancers, impedes cooling. Heating by RF elevated the temperatures of animal and human cancers by 5 to 9.5 C above that of healthy tissue. The heat eradicated the animal cancers without destruction of normal tissue. Radiofrequency therapy produced tissue necrosis or substantial regression of cancer in 21 patients.
Multi-institutional studies on clinical hyperthermia of deep-seated tumours were undertaken using 8 MHz radiofrequency capacitive heating devices (Thermotron RF-8) at seven institutions. Each institute was designated to treat specific organs. This paper contains the accumulations of the results obtained at different institutions charged for different tumours. Deep-seated tumours in the lung, stomach, pancreas, liver, urinary bladder and rectum were treated. A total of 177 cases examined from January 1985 to December 1988 included 96 cases (54%) treated with radiotherapy plus hyperthermia, among which 14 cases were pre-operative. Of 177 cases, 81 (46%) were treated with chemotherapy plus hyperthermia. Complete response (CR) and partial response (PR) were obtained in 80% of the cases with lung cancer, 39% with stomach cancer, 56% with liver cancer, 35% with pancreas cancer, 71% with urinary bladder cancer, 100% with primary rectal cancer, and 47% with recurrent rectal cancer. Thermometry was performed using two techniques; one is direct measurement of intratumour temperature in lung and liver cancers, the other is indirect measurement of intracavitary temperature for stomach, pancreas, urinary bladder and rectal cancers. Intratumour temperatures were measured in 30 of the 43 tumours of the lung and liver. The maximum tumour temperature was greater than 42 degrees C in 23 (77%) of the 30 tumours. Intracavitary temperatures were measured in 133 (99%) of the 134 tumours of stomach, pancreas, urinary bladder and rectum. An intracavitary temperature greater than 42 degrees C was obtained in 98 (73.7%) of the 133 tumours. The contribution of hyperthermia in improving the quality of life of patients under terminal care was also investigated. It was indicated that hyperthermia was one of the most effective treatment techniques for advanced or inoperable cases. In this study local control rate (LCR) was mainly discussed because the period of follow-up was only 3 years. Side-effects were observed in 37 cases (21%); main side-effects were fatty induration, pain during treatment and burn. However, no side-effects were severe enough to interrupt therapy.