Document Detail


Pathophysiological and vascular characteristics of tumours and their importance for hyperthermia: heterogeneity is the key issue.
MedLine Citation:
PMID:  20345270     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Tumour blood flow before and during clinically relevant mild hyperthermia exhibits pronounced heterogeneity. Flow changes upon heating are not predictable and are both spatially and temporally highly variable. Flow increases may result in improved heat dissipation to the extent that therapeutically relevant tissue temperatures may not be achieved. This holds especially true for tumours or tumour regions in which flow rates are substantially higher than in the surrounding normal tissues. Changes in tumour oxygenation tend to reflect alterations in blood flow upon hyperthermia. An initial improvement in the oxygenation status, followed by a return to baseline levels (or even a drop to below baseline at high thermal doses) has been reported for some tumours, whereas a predictable and universal occurrence of sustained increases in O(2) tensions upon mild hyperthermia is questionable and still needs to be verified in the clinical setting. Clarification of the pathogenetic mechanisms behind possible sustained increases is mandatory. High-dose hyperthermia leads to a decrease in the extracellular and intracellular pH and a deterioration of the energy status, both of which are known to be parameters capable of acting as direct sensitisers and thus pivotal factors in hyperthermia treatment. The role of the tumour microcirculatory function, hypoxia, acidosis and energy status is complex and is further complicated by a pronounced heterogeneity. These latter aspects require additional critical evaluation in clinically relevant tumour models in order for their impact on the response to heat to be clarified.
Authors:
Peter W Vaupel; Debra K Kelleher
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group     Volume:  26     ISSN:  1464-5157     ISO Abbreviation:  Int J Hyperthermia     Publication Date:  2010  
Date Detail:
Created Date:  2010-04-14     Completed Date:  2010-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508395     Medline TA:  Int J Hyperthermia     Country:  England    
Other Details:
Languages:  eng     Pagination:  211-23     Citation Subset:  IM    
Affiliation:
Department of Radiotherapy and Radiooncology, Klinikum rechts der Isar, Technical University, Munich, Germany.
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MeSH Terms
Descriptor/Qualifier:
Fever*
Hemorheology
Humans
Microcirculation*
Neoplasms / blood supply*,  physiopathology*,  therapy
Oxygen Consumption

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