High-temperature Hyperthermia Research Articles

Cell killing, DNA polymerase inactivation and radiosensitization to low dose rate irradiation by mild hyperthermia in four human cell lines.

Four human cell lines (one fibroblast, two melanoma and one glioma) were evaluated for their responses to hyperthermia and thermalradiosensitization. For mild hyperthermia (40-42 degrees C), there was little to no chronic thermotolerance development during protracted heating for up to 72 h. In addition, there was no significant thermotolerance for polymerase inactivation during mild hyperthermia. For high temperature hyperthermia, polymerase beta was more thermal sensitive than aphidicolin sensitive polymerase alpha + delta + epsilon, (termed polymerase alpha) but during mild hyperthermia ther relative sensitivities were reversed. Polymerase beta was resistant to mild hyperthermia and polymerase alpha was very sensitive. Within each cell line there was a correlation between polymerase alpha inactivation and the degree of radiosensitization (TER) and amongst the cell lines the most radiation resistant cell line had less polymerase alpha inactivation than the most sensitive cell line for similar values of TER's. These data indicate that, amongst the cell lines, radiosensitivity and polymerase alpha sensitivity may influence TER and that for a given cell line, or possibly tumour, polymerase alpha inactivation may have potential as an indicator to determine TER for mild hyperthermia treatments in radiosensitization to low dose rates.

Effect of protracted mild hyperthermia on polymerase activity in a human melanoma cell line.

Radioresistant human melanoma SkMel-3 was evaluated with its sensitivity to thermal cell killing and polymerase inactivation. Cells were heated from 40 to 45 degrees C and demonstrated no thermal tolerance development for any of the temperatures tested. In addition, at 45 degrees C the heat survival curve showed a large shoulder indicating capacity for accumulation of sublethal heat damage. Also at 45 degrees C heating polymerase beta was more sensitive than polymerase alpha + delta + epsilon. At 42 degrees C, the polymerase sensitivities were nearly the same but at the lower temperatures (41 and 40 degrees C) polymerase beta became progressively more resistant than the polymerase alpha + delta + epsilon. Thus, mild hyperthermia effects may be different than high temperature hyperthermia and may be related to polymerase alpha + delta + epsilon activity.

The threshold for thermally significant cavitation in dog's thigh muscle in vivo

In this study the threshold of thermally significant transient cavitation in vivo in dog's thigh muscle was investigated as a function of frequency from 0.246 MHz to 1.68 MHz. Cavitation, evidenced by strong emission of wide band noise monitored by a hydrophone, appeared to increase the energy absorption in tissue at the focal zone of a focused ultrasound beam as measured with an embedded thermocouple. This was indicated by a significant increase in the temperature, a loss of smooth temperature rise during the 1 s sound pulse and a significant reduction in the acoustic power transmitted through the thigh. This thermal phenomenon was associated with a strong emission of wide band noise which was monitored by a hydrophone. In addition, strong echoes appeared in ultrasound images during the pulses that caused the noise emission and the thermal effect. These echoes appeared preferentially at locations where there was acoustic heterogeneity. The measured cavitation pressure amplitude threshold was found to depend almost linearly on frequency with a slope of about 5.3 MPa MHz −1. (The extrapolated static pressure threshold was 0.6 MPa.) When these measured levels are compared to those typical of clinical application, it appears that the transient cavitation can be avoided when perfusion independent high temperature hyperthermia is induced with focused and pulsed ultrasound fields. However, intensities required during scanned focused ultrasound hyperthermia, where sharply focused transducers are used to heat large tumors at low frequencies (1 MHz or below), could rise above the threshold. Thus, care should be taken when focused ultrasound systems are designed so that the maximum peak pressure is below the threshold in order to avoid unpredictable biological effects induced by transient cavitation. Finally, it is unlikely that the present diagnostic ultrasound units which operate at higher frequencies and in pulsed mode could cause transient cavitation in vivo

Tumor control and therapeutic gain with different schedules of combined radiotherapy and local external hyperthermia in human cancer

Tumor control and therapeutic gain have been evaluated in a series of studies on patients with multiple lesions employing different protocols of combined radiotherapy (RT) and local external hyperthermia (HT). Tumor response has been evaluated during a follow-up ranging 6 to 18 months. Therapeutic enhancement factor (TEF) was defined as the ratio of thermal enhancement (TE) of tumors to TE of skin, where TE was clinically evaluated as the ratio of percent response (i.e., complete tumor clearance and moist desquamation, respectively) after combined modality to percent response after RT alone. Local tumor control was constantly better in lesions treated with any combined modalities in comparison with RT alone. The use of high RT dose per fraction appeared to increase tumor control only in the combined modalities groups, the immediate (so called “simultaneous”) schedule (HT at 42.5°C/45 min, applied immediately after each RT fraction, twice a week) being more effective than the delayed (so called “sequential”) treatment (HT at 42.5°C/45 min, delivered 4 h after each RT fraction, twice a week). The combination of high RT dose per fraction with high temperature HT (45°C for 30 min) achieved the best tumor control. No increased radiation skin reaction was observed when a conventional fraction size of RT was used (3 daily fractions of 1.5–2 Gy, 4 h interval between fractions) in association with HT (42.5°C/45 min, every other day, immediately after the second daily RT fraction). A remarkable enhancement of skin reaction was observed, however, when using high RT doses per fraction in association with 42.5°C HT, especially with the immediate treatment schedule. No enhancement of skin reaction was obtained after high RT doses per fractions and 45°C HT because an active skin cooling by means of circulating cold water was used in these cases. Consequently, a good TEF (1.58) was obtained when conventional RT doses per fraction were used in association with 42.5°C HT. TEF values of 1.40 and 1.15 were observed when high RT doses per fraction were employed in association with the delayed and immediate 42.5°C HT, respectively. HT at 45°C can be safely employed only when tumors can be heated selectively or at least preferentially in comparison with normal tissue; in the lesions treated with such a schedule a TEF of 2.10 was obtained.