An international joint statement about the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer was published in 2016, warning about the uncritical use of HIPEC outside controlled studies. This statement has now been updated after the most recent literature was reviewed by the participating study groups and societies. HIPEC became a treatment option in patients with advanced colon cancer after positive results of a randomized trial comparing surgery and HIPEC versus palliative treatment alone. Although this trial did not compare the added value of HIPEC to surgery alone, HIPEC for the treatment of peritoneal metastases was in the subsequent years generalized to many other cancer types associated with peritoneal carcinomatosis including epithelial ovarian cancer (EOC). In the meantime, new evidence from prospective randomized trials specifically for EOC-patients emerged, with however contradicting results and several quality aspects that made the interpretation of their findings critical. Moreover, three additional trials in colorectal cancer failed to confirm the previously presumed survival benefit through the implementation of HIPEC in peritoneally disseminated colorectal cancers. Based on a still unclear and inconsistent landscape, the authors conclude that HIPEC should remain within the remit of clinical trials for EOC-patients. Available evidence is not yet sufficient to justify its broad endorsement into the routine clinical practice.
- MeSH
- epiteliální ovariální karcinom patologie MeSH
- hypertermická intraperitoneální peroperační chemoterapie MeSH
- indukovaná hypertermie * metody MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- nádory vaječníků * farmakoterapie patologie MeSH
- prospektivní studie MeSH
- protokoly antitumorózní kombinované chemoterapie terapeutické užití MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Rakousko MeSH
- Švýcarsko MeSH
PURPOSE: To compare different thermal tissue models for head and neck hyperthermia treatment planning, and to assess the results using predicted and measured applied power data from clinical treatments. METHODS: Three commonly used temperature models from literature were analysed: "constant baseline", "constant thermal stress" and "temperature dependent". Power and phase data of 93 treatments of 20 head and neck patients treated with the HYPERcollar3D applicator were used. The impact on predicted median temperature T50 inside the target region was analysed with maximum allowed temperature of 44 °C in healthy tissue. The robustness of predicted T50 for the three models against the influence of blood perfusion, thermal conductivity and the assumed hotspot temperature level was analysed. RESULTS: We found an average predicted T50 of 41.0 ± 1.3 °C (constant baseline model), 39.9 ± 1.1 °C (constant thermal stress model) and 41.7 ± 1.1 °C (temperature dependent model). The constant thermal stress model resulted in the best agreement between the predicted power (P = 132.7 ± 45.9 W) and the average power measured during the hyperthermia treatments (P = 129.1 ± 83.0 W). CONCLUSION: The temperature dependent model predicts an unrealistically high T50. The power values for the constant thermal stress model, after scaling simulated maximum temperatures to 44 °C, matched best to the average measured powers. We consider this model to be the most appropriate for temperature predictions using the HYPERcollar3D applicator, however further studies are necessary for developing of robust temperature model for tissues during heat stress.
Chemotherapy is the most prominent route in cancer therapy for prolonging the lifespan of cancer patients. However, its non-target specificity and the resulting off-target cytotoxicities have been reported. Recent in vitro and in vivo studies using magnetic nanocomposites (MNCs) for magnetothermal chemotherapy may potentially improve the therapeutic outcome by increasing the target selectivity. In this review, magnetic hyperthermia therapy and magnetic targeting using drug-loaded MNCs are revisited, focusing on magnetism, the fabrication and structures of magnetic nanoparticles, surface modifications, biocompatible coating, shape, size, and other important physicochemical properties of MNCs, along with the parameters of the hyperthermia therapy and external magnetic field. Due to the limited drug-loading capacity and low biocompatibility, the use of magnetic nanoparticles (MNPs) as drug delivery system has lost traction. In contrast, MNCs show higher biocompatibility, multifunctional physicochemical properties, high drug encapsulation, and multi-stages of controlled release for localized synergistic chemo-thermotherapy. Further, combining various forms of magnetic cores and pH-sensitive coating agents can generate a more robust pH, magneto, and thermo-responsive drug delivery system. Thus, MNCs are ideal candidate as smart and remotely guided drug delivery system due to a) their magneto effects and guide-ability by the external magnetic fields, b) on-demand drug release performance, and c) thermo-chemosensitization under an applied alternating magnetic field where the tumor is selectively incinerated without harming surrounding non-tumor tissues. Given the important effects of synthesis methods, surface modifications, and coating of MNCs on their anticancer properties, we reviewed the most recent studies on magnetic hyperthermia, targeted drug delivery systems in cancer therapy, and magnetothermal chemotherapy to provide insights on the current development of MNC-based anticancer nanocarrier.
- MeSH
- indukovaná hypertermie * metody MeSH
- lidé MeSH
- magnetické pole MeSH
- magnetismus MeSH
- nádory * farmakoterapie MeSH
- systémy cílené aplikace léků metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Přístrojově asistovaná intravezikální chemoterapie má za cíl zvýšit účinnost intravezikální chemoterapie při léčbě svalovinu neinfiltrujících nádorů močového měchýře. V současné době je její použití omezeno na případy, kdy po selhání (nebo v případě intolerance či nedostupnosti) intravezikální imunoterapie BCG vakcínou nelze provést radikální cystektomii buďto z důvodu špatného celkového stavu pacienta, nebo z důvodu odmítnutí operace. V České republice jsou dostupné dvě metody této léčby založené na využití tepelné energie. Článek přináší přehledné informace o obou těchto metodách s důrazem na praktické aspekty při jejich použití.
Device-assisted intravesical chemotherapy aims to increase the efficacy of intravesical chemotherapy in the treatment of non-muscle-invasive bladder cancer. Currently, its use is limited to cases where radical cystectomy cannot be performed after failure (or intolerance or unavailability) of intravesical immunotherapy with BCG vaccine, either because of poor performance status of the patient or because of refusal of surgery. In the Czech Republic, two methods of this treatment based on the use of thermal energy are available. The article provides summary of both these methods with an emphasis on practical aspects of their use.
- Klíčová slova
- termochemoterapie, termochemoterapie, radiofrekvenční termoterapie, intravezikální chemoterapie,
- MeSH
- indukovaná hypertermie * metody MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- nádory močového měchýře * farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
DNA repair pathways are essential for maintaining genome stability, and understanding the regulation of these mechanisms may help in the design of new strategies for treatments, the prevention of platinum-based chemoresistance, and the prolongation of overall patient survival not only with respect to ovarian cancer. The role of hyperthermic intraperitoneal chemotherapy (HIPEC) together with cytoreductive surgery (CRS) and adjuvant systemic chemotherapy is receiving more interest in ovarian cancer (OC) treatment because of the typical peritoneal spread of the disease. The aim of our study was to compare the expression level of 84 genes involved in the DNA repair pathway in tumors and the paired peritoneal metastasis tissue of patients treated with CRS/platinum-based HIPEC with respect to overall patient survival, presence of peritoneal carcinomatosis, treatment response, and alterations in the BRCA1 and BRCA2 genes. Tumors and metastatic tissue from 28 ovarian cancer patients collected during cytoreductive surgery before HIPEC with cisplatin were used for RNA isolation and subsequent cDNA synthesis. Quantitative real-time PCR followed. The most interesting findings of our study are undoubtedly the gene interactions among the genes CCNH, XPA, SLK, RAD51C, XPA, NEIL1, and ATR for primary tumor tissue and ATM, ATR, BRCA2, CDK7, MSH2, MUTYH, POLB, and XRCC4 for metastases. Another interesting finding is the correlation between gene expression and overall survival (OS), where a low expression correlates with a worse OS.
- MeSH
- DNA-glykosylasy * genetika MeSH
- hypertermická intraperitoneální peroperační chemoterapie MeSH
- indukovaná hypertermie * metody MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- míra přežití MeSH
- nádory vaječníků * farmakoterapie genetika MeSH
- oprava DNA genetika MeSH
- přežití po terapii bez příznaků nemoci MeSH
- protokoly antitumorózní kombinované chemoterapie terapeutické užití MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Kuncová J. Intravezikální, radiofrekvencí indukovaná chemohypertermie v léčbě svalovinu neinfiltrujících nádorů močového měchýře. Intravezikální, radiofrekvencí indukovaná chemohypertermie Synergo® RITE patří mezi metody tzv. přístrojově asistované instilace vyvinuté ke zvýšení efektivity intravezikání chemoterapie v léčbě svalovinu neinfiltrujících nádorů močového měchýře. Léčba touto metodou je v současné době v České republice schválená jako standardní v přesně definovaných indikacích. V přehledovém článku jsou zmíněny mechanismy účinku termoterapie a radiofrekvenčního záření na nádorové tkáně. V textu jsou uvedeny základní informace o Synergo® RITE systému, o indikacích a protokolech léčby a nežádoucí účincích terapie a uvedena jsou i data z klinických studií.
Kuncová J. Intravesical, radiofrequency-induced chemohyperthermia in the treatment of non-muscle invasive bladder cancer. Intravesical, radiofrequency-induced chemohyperthermia Synergo® RITE is one of the so-called device-assisted instillation methods developed to increase the effectiveness of intravesical chemotherapy in the treatment of non-muscle invasive bladder tumors. Treatment with this method is currently approved as standard in precisely defined indications in the Czech Republic. The mechanisms of the effect of thermotherapy and radiofrequency treatment on tumor tissues are discussed in this review article. The text provides basic information on the Synergo® RITE system, treatment indications, protocols and side effects of therapy, and also data from clinical trials.
- Klíčová slova
- radiofrekvencí indukovaná chemohypertermie,
- MeSH
- indukovaná hypertermie * metody MeSH
- lidé MeSH
- nádory močového měchýře * terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
A number of materials are studied in the field of magnetic hyperthermia. In general, the most promising ones appear to be iron oxide particle nanosystems. This is also indicated in some clinical trial studies where iron-based oxides were used. On the other hand, the type of material itself provides a number of variations on how to tune hyperthermia indicators. In this paper, magnetite nanoparticles in various forms were analyzed. The nanoparticles differed in the core size as well as in the form of their arrangement. The arrangement was determined by the nature of the surfactant. The individual particles were covered chemically by dextran; in the case of chain-like particles, they were encapsulated naturally in a lipid bilayer. It was shown that in the case of chain-like nanoparticles, except for relaxation, a contribution from magnetic hysteresis to the heating process also appears. The influence of the chosen methodology of magnetic field generation was also analyzed. In addition, the influence of the chosen methodology of magnetic field generation was analyzed. The application of a rotating magnetic field was shown to be more efficient in generating heat than the application of an alternating magnetic field. However, the degree of efficiency depended on the arrangement of the magnetite nanoparticles. The difference in the efficiency of the rotating magnetic field versus the alternating magnetic field was much more pronounced for individual nanoparticles (in the form of a magnetic fluid) than for systems containing chain nanoparticles (magnetosomes and a mix of magnetic fluid with magnetosomes in a ratio 1:1).
MXenes and their related nanocomposites with superior physicochemical properties such as high surface area, ease of synthesis and functionalization, high drug loading capacity, collective therapy potentials, pH-triggered drug release behavior, high photothermal conversion, and excellent photodynamic efficiency have been explored as alluring materials in photomedicine; the application of photons in medicine is facilitated for imaging and various disease treatment methods such as photothermal cancer/tumor ablation. Non-invasive theranostic strategies with synergistic activities have been developed using photothermal, photodynamic, and magnetic therapies together with remotely controlled drug/gene delivery for the diagnosis and treatment of various malignant diseases. Photothermal/photodynamic therapy and photoacoustic imaging using MXene-based structures have shown great promise in cancer phototherapy. However, hybridization and surface functionalization should be further explored to obtain biocompatible MXene-based composites/platforms with unique properties, high stability, and improved functionality in photomedicine. Toxicological and long-term biosafety assessments as well as clinical translation evaluations ought to be given high priority in research. Although some limited studies have revealed the excellent potentials of MXenes and their derivatives in photomedicine, further steps should be taken towards extensive research and detailed analysis in the field of optimizing the properties and improving the performance of these materials with a clinical and industrial outlook. Optical biosensing platforms have been developed along with electrochemical sensors and wearable sensors constructed from MXenes and their derivatives; future studies warrant the comprehensive analysis of optical transduction aspects such as colorimetry, electrochemiluminescence, photoluminescence, surface-enhanced Raman scattering, and surface plasmon resonance. Herein, the potentials of MXenes in photomedicine are deliberated encompassing important challenges and future research directions.
- MeSH
- fotochemoterapie * MeSH
- fototerapie metody MeSH
- indukovaná hypertermie * metody MeSH
- lidé MeSH
- nádory * diagnostické zobrazování farmakoterapie MeSH
- nanokompozity * chemie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Perkutánní termoablace je alternativní metoda léčby lokalizovaných tumorů ledvin (T1a). Využívá se především u starších polymorbidních pacientů, kteří nejsou indikování k chirurgickému zákroku. Pooperační výsledek z hlediska celkového přežití po jednom roce je obdobný u pacientů po termoablaci i resekci. Celkové přežití v delším intervalu je lepší u pacientů po resekci ve srovnání se skupinou po termoablaci. Chirurgické řešení této skupiny tumorů je nadále metodou volby.
Percutaneous thermoablation is an alternative method of treatment for localized renal tumors (T1a). Its application is mainly in elderly polymorbid patients who are not candidates for surgery. The postoperative outcome in terms of overall survival at 1 year is similar in patients after thermoablation and resection. Overall survival at longer interval is better in the resection group compared with the thermoablation group. Surgical management of this group of tumors remains the method of choice.
