Abstract

The therapeutic application of heat is very effective in cancer treatment. Both hyperthermia, i.e., heating to 39–45 °C to induce sensitization to radiotherapy and chemotherapy, and thermal ablation, where temperatures beyond 50 °C destroy tumor cells directly are frequently applied in the clinic. Achievement of an effective treatment requires high quality heating equipment, precise thermal dosimetry, and adequate quality assurance. Several types of devices, antennas and heating or power delivery systems have been proposed and developed in recent decades. These vary considerably in technique, heating depth, ability to focus, and in the size of the heating focus. Clinically used heating techniques involve electromagnetic and ultrasonic heating, hyperthermic perfusion and conductive heating. Depending on clinical objectives and available technology, thermal therapies can be subdivided into three broad categories: local, locoregional, or whole body heating. Clinically used local heating techniques include interstitial hyperthermia and ablation, high intensity focused ultrasound (HIFU), scanned focused ultrasound (SFUS), electroporation, nanoparticle heating, intraluminal heating and superficial heating. Locoregional heating techniques include phased array systems, capacitive systems and isolated perfusion. Whole body techniques focus on prevention of heat loss supplemented with energy deposition in the body, e.g., by infrared radiation. This review presents an overview of clinical hyperthermia and ablation devices used for local, locoregional, and whole body therapy. Proven and experimental clinical applications of thermal ablation and hyperthermia are listed. Methods for temperature measurement and the role of treatment planning to control treatments are discussed briefly, as well as future perspectives for heating technology for the treatment of tumors.

摘要

热量的治疗应用在癌症治疗中非常有效。热疗，即加热到39–45°C以引起对放射疗法和化学疗法的敏感性，以及热消融（温度超过50°C会直接破坏肿瘤细胞）均在临床上经常使用。要获得有效的治疗，就需要高质量的加热设备，精确的热剂量测定法和足够的质量保证。在最近的几十年中已经提出并开发了几种类型的设备，天线和加热或功率传输系统。这些在技术，加热深度，聚焦能力以及加热焦点的大小上有很大不同。临床上使用的加热技术包括电磁和超声加热，热灌注和传导加热。根据临床目标和可用技术，热疗法可分为三大类：局部加热，局部加热或全身加热。临床上使用的局部加热技术包括间隙热疗和消融，高强度聚焦超声（HIFU），扫描聚焦超声（SFUS），电穿孔，纳米颗粒加热，腔内加热和表面加热。局部加热技术包括相控阵系统，电容系统和隔离式灌注。全身技术的重点是防止热量流失，并补充能量在体内的沉积，例如通过红外线辐射。这篇综述介绍了用于局部，局部和全身治疗的临床热疗和消融设备的概述。列出了热消融和热疗的经过验证和实验的临床应用。