1
|
Kwon S, Jung S, Baek SH. Combination Therapy of Radiation and Hyperthermia, Focusing on the Synergistic Anti-Cancer Effects and Research Trends. Antioxidants (Basel) 2023; 12:antiox12040924. [PMID: 37107299 PMCID: PMC10136118 DOI: 10.3390/antiox12040924] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Despite significant therapeutic advances, the toxicity of conventional therapies remains a major obstacle to their application. Radiation therapy (RT) is an important component of cancer treatment. Therapeutic hyperthermia (HT) can be defined as the local heating of a tumor to 40-44 °C. Both RT and HT have the advantage of being able to induce and regulate oxidative stress. Here, we discuss the effects and mechanisms of RT and HT based on experimental research investigations and summarize the results by separating them into three phases. Phase (1): RT + HT is effective and does not provide clear mechanisms; phase (2): RT + HT induces apoptosis via oxygenation, DNA damage, and cell cycle arrest; phase (3): RT + HT improves immunological responses and activates immune cells. Overall, RT + HT is an effective cancer modality complementary to conventional therapy and stimulates the immune response, which has the potential to improve cancer treatments, including immunotherapy, in the future.
Collapse
Affiliation(s)
- Seeun Kwon
- College of Korean Medicine, Dongguk University, 32 Dongguk-ro, Ilsandong-gu, Goyang-si 10326, Republic of Korea
| | - Sumin Jung
- College of Korean Medicine, Dongguk University, 32 Dongguk-ro, Ilsandong-gu, Goyang-si 10326, Republic of Korea
| | - Seung Ho Baek
- College of Korean Medicine, Dongguk University, 32 Dongguk-ro, Ilsandong-gu, Goyang-si 10326, Republic of Korea
| |
Collapse
|
2
|
Evaluation of a Developed MRI-Guided Focused Ultrasound System in 7 T Small Animal MRI and Proof-of-Concept in a Prostate Cancer Xenograft Model to Improve Radiation Therapy. Cells 2023; 12:cells12030481. [PMID: 36766824 PMCID: PMC9914251 DOI: 10.3390/cells12030481] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/17/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Focused ultrasound (FUS) can be used to physiologically change or destroy tissue in a non-invasive way. A few commercial systems have clinical approval for the thermal ablation of solid tumors for the treatment of neurological diseases and palliative pain management of bone metastases. However, the thermal effects of FUS are known to lead to various biological effects, such as inhibition of repair of DNA damage, reduction in tumor hypoxia, and induction of apoptosis. Here, we studied radiosensitization as a combination therapy of FUS and RT in a xenograft mouse model using newly developed MRI-compatible FUS equipment. Xenograft tumor-bearing mice were produced by subcutaneous injection of the human prostate cancer cell line PC-3. Animals were treated with FUS in 7 T MRI at 4.8 W/cm2 to reach ~45 °C and held for 30 min. The temperature was controlled via fiber optics and proton resonance frequency shift (PRF) MR thermometry in parallel. In the combination group, animals were treated with FUS followed by X-ray at a single dose of 10 Gy. The effects of FUS and RT were assessed via hematoxylin-eosin (H&E) staining. Tumor proliferation was detected by the immunohistochemistry of Ki67 and apoptosis was measured by a TUNEL assay. At 40 days follow-up, the impact of RT on cancer cells was significantly improved by FUS as demonstrated by a reduction in cell nucleoli from 189 to 237 compared to RT alone. Inhibition of tumor growth by 4.6 times was observed in vivo in the FUS + RT group (85.3%) in contrast to the tumor volume of 393% in the untreated control. Our results demonstrated the feasibility of combined MRI-guided FUS and RT for the treatment of prostate cancer in a xenograft mouse model and may provide a chance for less invasive cancer therapy through radiosensitization.
Collapse
|
3
|
Prasad B, Shaikh S, Saini R, Wang Q, Zadoo S, Sadaphal V, Greenberg DE, Chopra R. Quantifying the relationship between biofilm reduction and thermal tissue damage on metal implants exposed to alternating magnetic fields. Int J Hyperthermia 2022; 39:713-724. [DOI: 10.1080/02656736.2022.2065038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Bibin Prasad
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Sumbul Shaikh
- Department of Research Administration, Children’s Medical Center of Dallas, Dallas, TX, USA
| | - Reshu Saini
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Qi Wang
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Serena Zadoo
- Department of Internal Medicine, Infectious Diseases and Geographic Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Varun Sadaphal
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - David E. Greenberg
- Department of Internal Medicine, Infectious Diseases and Geographic Medicine, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Microbiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Rajiv Chopra
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
4
|
Heterogeneous Heat Absorption Is Complementary to Radiotherapy. Cancers (Basel) 2022; 14:cancers14040901. [PMID: 35205649 PMCID: PMC8870118 DOI: 10.3390/cancers14040901] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/20/2022] [Accepted: 01/30/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary This review shows the advantages of heterogeneous heating of selected malignant cells in harmonic synergy with radiotherapy. The main clinical achievement of this complementary therapy is its extreme safety and minimal adverse effects. Combining the two methods opens a bright perspective, transforming the local radiotherapy to the antitumoral impact on the whole body, destroying the distant metastases by “teaching” the immune system about the overall danger of malignancy. Abstract (1) Background: Hyperthermia in oncology conventionally seeks the homogeneous heating of the tumor mass. The expected isothermal condition is the basis of the dose calculation in clinical practice. My objective is to study and apply a heterogenic temperature pattern during the heating process and show how it supports radiotherapy. (2) Methods: The targeted tissue’s natural electric and thermal heterogeneity is used for the selective heating of the cancer cells. The amplitude-modulated radiofrequency current focuses the energy absorption on the membrane rafts of the malignant cells. The energy partly “nonthermally” excites and partly heats the absorbing protein complexes. (3) Results: The excitation of the transmembrane proteins induces an extrinsic caspase-dependent apoptotic pathway, while the heat stress promotes the intrinsic caspase-dependent and independent apoptotic signals generated by mitochondria. The molecular changes synergize the method with radiotherapy and promote the abscopal effect. The mild average temperature (39–41 °C) intensifies the blood flow for promoting oxygenation in combination with radiotherapy. The preclinical experiences verify, and the clinical studies validate the method. (4) Conclusions: The heterogenic, molecular targeting has similarities with DNA strand-breaking in radiotherapy. The controlled energy absorption allows using a similar energy dose to radiotherapy (J/kg). The two therapies are synergistically combined.
Collapse
|
5
|
|
6
|
Ankjærgaard C, Johansen A, von Staffeldt M, Andersen C, Madsen D, Behrens C. Irradiation of subcutaneous mouse tumors with a clinical linear accelerator validated by alanine dosimetry. RADIAT MEAS 2021. [DOI: 10.1016/j.radmeas.2021.106636] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
7
|
Wust P, Stein U, Ghadjar P. Non-thermal membrane effects of electromagnetic fields and therapeutic applications in oncology. Int J Hyperthermia 2021; 38:715-731. [PMID: 33910472 DOI: 10.1080/02656736.2021.1914354] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The temperature-independent effects of electromagnetic fields (EMF) have been controversial for decades. Here, we critically analyze the available literature on non-thermal effects of radiofrequency (RF) and microwave EMF. We present a literature review of preclinical and clinical data on non-thermal antiproliferative effects of various EMF applications, including conventional RF hyperthermia (HT, cRF-HT). Further, we suggest and evaluate plausible biophysical and electrophysiological models to decipher non-thermal antiproliferative membrane effects. Available preclinical and clinical data provide sufficient evidence for the existence of non-thermal antiproliferative effects of exposure to cRF-HT, and in particular, amplitude modulated (AM)-RF-HT. In our model, transmembrane ion channels function like RF rectifiers and low-pass filters. cRF-HT induces ion fluxes and AM-RF-HT additionally promotes membrane vibrations at specific resonance frequencies, which explains the non-thermal antiproliferative membrane effects via ion disequilibrium (especially of Ca2+) and/or resonances causing membrane depolarization, the opening of certain (especially Ca2+) channels, or even hole formation. AM-RF-HT may be tumor-specific owing to cancer-specific ion channels and because, with increasing malignancy, membrane elasticity parameters may differ from that in normal tissues. Published literature suggests that non-thermal antiproliferative effects of cRF-HT are likely to exist and could present a high potential to improve future treatments in oncology.
Collapse
Affiliation(s)
- Peter Wust
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ulrike Stein
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max-Delbrück-Centrum (MDC), Berlin, Germany
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| |
Collapse
|
8
|
Rajaee Z, Khoei S, Mahdavian A, Shirvalilou S, Mahdavi SR, Ebrahimi M. Radio-thermo-sensitivity Induced by Gold Magnetic Nanoparticles in the Monolayer Culture of Human Prostate Carcinoma Cell Line DU145. Anticancer Agents Med Chem 2021; 20:315-324. [PMID: 31840615 DOI: 10.2174/1871520620666191216113052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/09/2019] [Accepted: 10/16/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Prostate cancer is the second cause of death in men worldwide. In this study, the cytotoxic effects of PLGA polymer-coated gold Magnetic Nanoparticles (MGNPs), as a novel treatment to enhance radiation and thermal sensitivity in the presence of hyperthermia (43°C) and electron beam, on DU145 prostate cancer cells were investigated. METHODS Nanoparticles were characterized using TEM, DLS, XRD and SAED methods. MGNPs entrance into the cells was determined using Prussian blue staining and TEM. Furthermore, the cytotoxic effects of combinatorial treatment modalities were assessed by applying colony and sphere formation assay. RESULTS Our results revealed that the decrease of colony and sphere numbers after combinatorial treatment of hyperthermia and radiation in the presence of nanoparticles was significantly higher than the other treatment groups (P<0.05). This treatment method proved that it has the capability of eliminating most of the DU145 cells (80-100%), and increased the value of the linear parameter (α) to 4.86 times. CONCLUSION According to the study, magnetic gold nanoparticles, in addition to having a high atomic number, can effectively transmit heat produced inside them to the adjacent regions under hyperthermia, which increases the effects of radio-thermosensitivity, respectively.
Collapse
Affiliation(s)
- Zhila Rajaee
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Samideh Khoei
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Finetech in Medicine Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Mahdavian
- Polymer Science Department, Iran Polymer & Petrochemical Institute, Tehran, Iran
| | - Sakine Shirvalilou
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Finetech in Medicine Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Seied R Mahdavi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Marzieh Ebrahimi
- Department of Stem Cells and Developmental Biology, Cell Science Research Centre, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| |
Collapse
|
9
|
Alshaibi HF, Al-shehri B, Hassan B, Al-zahrani R, Assiss T. Modulated Electrohyperthermia: A New Hope for Cancer Patients. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8814878. [PMID: 33274226 PMCID: PMC7683119 DOI: 10.1155/2020/8814878] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/14/2020] [Accepted: 10/31/2020] [Indexed: 12/26/2022]
Abstract
According to the World Health Organization, the prevalence of cancer has increased worldwide. Oncological hyperthermia is a group of methods that overheat the malignant tissues locally or systematically. Nevertheless, hyperthermia is not widely accepted, primarily because of the lack of selectivity for cancer cells and because the temperature-triggered higher blood flow increases the nutrient supply to the tumor, raising the risk of metastases. These problems with classical hyperthermia led to the development of modulated electrohyperthermia (mEHT). The biophysical differences of the cancer cells and their healthy hosts allow for selective energy absorption on the membrane rafts of the plasma membrane of the tumor cells, triggering immunogenic cell death. Currently, this method is used in only 34 countries. The effectiveness of conventional oncotherapies increases when it is applied in combination with mEHT. In silico, in vitro, and in vivo preclinical research studies have all shown the extraordinary ability of mEHT to kill malignant cells. Clinical applications have improved the quality of life and the survival of patients. For these reasons, many other research studies are presently in progress worldwide. Thus, the objective of this review is to highlight the capabilities and advantages of mEHT and provide new hopes for cancer patients worldwide.
Collapse
Affiliation(s)
- Huda F. Alshaibi
- Faculty of Science Biochemistry Department, King Abdulaziz University, Saudi Arabia P.O. Box 52502, Jeddah 21573
| | - Bashayr Al-shehri
- Faculty of Science Biochemistry Department, Undergraduate Students at King Abdulaziz University, Saudi Arabia
| | - Basmah Hassan
- Faculty of Science Biochemistry Department, Undergraduate Students at King Abdulaziz University, Saudi Arabia
| | - Raghad Al-zahrani
- Faculty of Science Biochemistry Department, Undergraduate Students at King Abdulaziz University, Saudi Arabia
| | - Taghreed Assiss
- Faculty of Science Biochemistry Department, Undergraduate Students at King Abdulaziz University, Saudi Arabia
| |
Collapse
|
10
|
Brero F, Albino M, Antoccia A, Arosio P, Avolio M, Berardinelli F, Bettega D, Calzolari P, Ciocca M, Corti M, Facoetti A, Gallo S, Groppi F, Guerrini A, Innocenti C, Lenardi C, Locarno S, Manenti S, Marchesini R, Mariani M, Orsini F, Pignoli E, Sangregorio C, Veronese I, Lascialfari A. Hadron Therapy, Magnetic Nanoparticles and Hyperthermia: A Promising Combined Tool for Pancreatic Cancer Treatment. NANOMATERIALS 2020; 10:nano10101919. [PMID: 32993001 PMCID: PMC7600442 DOI: 10.3390/nano10101919] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 12/24/2022]
Abstract
A combination of carbon ions/photons irradiation and hyperthermia as a novel therapeutic approach for the in-vitro treatment of pancreatic cancer BxPC3 cells is presented. The radiation doses used are 0–2 Gy for carbon ions and 0–7 Gy for 6 MV photons. Hyperthermia is realized via a standard heating bath, assisted by magnetic fluid hyperthermia (MFH) that utilizes magnetic nanoparticles (MNPs) exposed to an alternating magnetic field of amplitude 19.5 mTesla and frequency 109.8 kHz. Starting from 37 °C, the temperature is gradually increased and the sample is kept at 42 °C for 30 min. For MFH, MNPs with a mean diameter of 19 nm and specific absorption rate of 110 ± 30 W/gFe3o4 coated with a biocompatible ligand to ensure stability in physiological media are used. Irradiation diminishes the clonogenic survival at an extent that depends on the radiation type, and its decrease is amplified both by the MNPs cellular uptake and the hyperthermia protocol. Significant increases in DNA double-strand breaks at 6 h are observed in samples exposed to MNP uptake, treated with 0.75 Gy carbon-ion irradiation and hyperthermia. The proposed experimental protocol, based on the combination of hadron irradiation and hyperthermia, represents a first step towards an innovative clinical option for pancreatic cancer.
Collapse
Affiliation(s)
- Francesca Brero
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
- Correspondence: (F.B.); (A.L.); Tel.: +39-0382-987-483 (F.B. & A.L.)
| | - Martin Albino
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy; (M.A.); (A.G.); (C.I.); (C.S.)
| | - Antonio Antoccia
- Dipartimento di Scienze and INFN, Università Roma Tre, 00146 Roma, Italy; (A.A.); (F.B.)
| | - Paolo Arosio
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Matteo Avolio
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
| | - Francesco Berardinelli
- Dipartimento di Scienze and INFN, Università Roma Tre, 00146 Roma, Italy; (A.A.); (F.B.)
| | - Daniela Bettega
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Paola Calzolari
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Mario Ciocca
- Fondazione CNAO, 27100 Pavia, Italy; (M.C.); (A.F.)
| | - Maurizio Corti
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
| | | | - Salvatore Gallo
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Flavia Groppi
- Dipartimento di Fisica, Università degli Studi di Milano and INFN, Lab. LASA, 20090 Segrate (MI), Italy; (F.G.); (S.M.)
| | - Andrea Guerrini
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy; (M.A.); (A.G.); (C.I.); (C.S.)
| | - Claudia Innocenti
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy; (M.A.); (A.G.); (C.I.); (C.S.)
- ICCOM-CNR, 50019 Sesto Fiorentino (FI), Italy
| | - Cristina Lenardi
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
- C.I.Ma.I.Na., Centro Interdisciplinare Materiali e Interfacce Nanostrutturati, 20133 Milano, Italy
| | - Silvia Locarno
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Simone Manenti
- Dipartimento di Fisica, Università degli Studi di Milano and INFN, Lab. LASA, 20090 Segrate (MI), Italy; (F.G.); (S.M.)
| | - Renato Marchesini
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Manuel Mariani
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
| | - Francesco Orsini
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Emanuele Pignoli
- Fondazione IRCSS Istituto Nazionale dei tumori, 20133 Milano, Italy;
| | - Claudio Sangregorio
- Dipartimento di Chimica, Università di Firenze and INSTM, 50019 Sesto Fiorentino (FI), Italy; (M.A.); (A.G.); (C.I.); (C.S.)
- ICCOM-CNR, 50019 Sesto Fiorentino (FI), Italy
- INFN, Sezione di Firenze, 50019 Sesto Fiorentino (FI), Italy
| | - Ivan Veronese
- Dipartimento di Fisica and INFN, Università degli Studi di Milano, 20133 Milano, Italy; (P.A.); (D.B.); (P.C.); (S.G.); (C.L.); (S.L.); (R.M.); (F.O.); (I.V.)
| | - Alessandro Lascialfari
- Dipartimento di Fisica and INFN, Università degli Studi di Pavia, 27100 Pavia, Italy; (M.A.); (M.C.); (M.M.)
- Correspondence: (F.B.); (A.L.); Tel.: +39-0382-987-483 (F.B. & A.L.)
| |
Collapse
|
11
|
Krenacs T, Meggyeshazi N, Forika G, Kiss E, Hamar P, Szekely T, Vancsik T. Modulated Electro-Hyperthermia-Induced Tumor Damage Mechanisms Revealed in Cancer Models. Int J Mol Sci 2020; 21:E6270. [PMID: 32872532 PMCID: PMC7504298 DOI: 10.3390/ijms21176270] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 12/18/2022] Open
Abstract
The benefits of high-fever range hyperthermia have been utilized in medicine from the Ancient Greek culture to the present day. Amplitude-modulated electro-hyperthermia, induced by a 13.56 MHz radiofrequency current (mEHT, or Oncothermia), has been an emerging means of delivering loco-regional clinical hyperthermia as a complementary of radiation-, chemo-, and molecular targeted oncotherapy. This unique treatment exploits the metabolic shift in cancer, resulting in elevated oxidative glycolysis (Warburg effect), ion concentration, and electric conductivity. These promote the enrichment of electric fields and induce heat (controlled at 42 °C), as well as ion fluxes and disequilibrium through tumor cell membrane channels. By now, accumulating preclinical studies using in vitro and in vivo models of different cancer types have revealed details of the mechanism and molecular background of the oncoreductive effects of mEHT monotherapy. These include the induction of DNA double-strand breaks, irreversible heath and cell stress, and programmed cells death; the upregulation of molecular chaperones and damage (DAMP) signaling, which may contribute to a secondary immunogenic tumor cell death. In combination therapies, mEHT proved to be a good chemosensitizer through increasing drug uptake and tumor reductive effects, as well as a good radiosensitizer by downregulating hypoxia-related target genes. Recently, immune stimulation or intratumoral antigen-presenting dendritic cell injection have been able to extend the impact of local mEHT into a systemic "abscopal" effect. The complex network of pathways emerging from the published mEHT experiments has not been overviewed and arranged yet into a framework to reveal links between the pieces of the "puzzle". In this paper, we review the mEHT-related damage mechanisms published in tumor models, which may allow some geno-/phenotype treatment efficiency correlations to be exploited both in further research and for more rational clinical treatment planning when mEHT is involved in combination therapies.
Collapse
Affiliation(s)
- Tibor Krenacs
- Department of Pathology and Experimental Cancer Research, Semmelweis University, H-1085 Budapest, Hungary; (N.M.); (G.F.); (T.S.)
| | - Nora Meggyeshazi
- Department of Pathology and Experimental Cancer Research, Semmelweis University, H-1085 Budapest, Hungary; (N.M.); (G.F.); (T.S.)
| | - Gertrud Forika
- Department of Pathology and Experimental Cancer Research, Semmelweis University, H-1085 Budapest, Hungary; (N.M.); (G.F.); (T.S.)
| | - Eva Kiss
- Institute of Oncology at 1st Department of Internal Medicine, Semmelweis University, H-1083 Budapest, Hungary;
| | - Peter Hamar
- Institute of Translational Medicine, Semmelweis University, H-1094 Budapest, Hungary; (P.H.); (T.V.)
| | - Tamas Szekely
- Department of Pathology and Experimental Cancer Research, Semmelweis University, H-1085 Budapest, Hungary; (N.M.); (G.F.); (T.S.)
| | - Tamas Vancsik
- Institute of Translational Medicine, Semmelweis University, H-1094 Budapest, Hungary; (P.H.); (T.V.)
| |
Collapse
|
12
|
Wang Y, Zou L, Qiang Z, Jiang J, Zhu Z, Ren J. Enhancing Targeted Cancer Treatment by Combining Hyperthermia and Radiotherapy Using Mn–Zn Ferrite Magnetic Nanoparticles. ACS Biomater Sci Eng 2020; 6:3550-3562. [DOI: 10.1021/acsbiomaterials.0c00287] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Yijue Wang
- Institute of Nano and Biopolymeric Materials, School of Materials Science and Engineering, Tongji University, Shanghai 201804, China
| | - Liqing Zou
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Zhe Qiang
- School of Polymer Science and Engineering, The University of Southern Mississippi, Hattiesburg, Mississippi 39406, United States
| | - Jianhai Jiang
- NHC Key Laboratory of Glycoconjugates Research, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Zhengfei Zhu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
- Institute of Thoracic Oncology, Fudan University, Shanghai 200032, China
| | - Jie Ren
- Institute of Nano and Biopolymeric Materials, School of Materials Science and Engineering, Tongji University, Shanghai 201804, China
| |
Collapse
|
13
|
Jun HJ, Park SJ, Kang HJ, Lee GY, Lee N, Park JH, Yoo HS. The Survival Benefit of Combination Therapy With Mild Temperature Hyperthermia and an Herbal Prescription of Gun-Chil-Jung in 54 Cancer Patients Treated With Chemotherapy or Radiation Therapy: A Retrospective Study. Integr Cancer Ther 2020; 19:1534735420926583. [PMID: 32449629 PMCID: PMC7249570 DOI: 10.1177/1534735420926583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/25/2020] [Accepted: 04/23/2020] [Indexed: 12/18/2022] Open
Abstract
Background: The combination of herbal medicine with conventional treatment increases the survival rate of cancer patients, but the effect is not great. Hyperthermia may have a synergistic effect with herbal medicine alongside conventional medicine. Objective: To monitor the efficacy of hyperthermia together with Gun-Chil-Jung (GCJ) capsule for event-free survival (EFS) and overall survival (OS) for the treatment of various cancers. Methods: We collected data retrospectively on 54 cancer patients of all stages. They were divided into 4 groups according to each hyperthermia or GCJ treatment period. Hyperthermia with 0.46 MHz radiofrequency wave was applied a power of 50 to 100 W for 70 minutes. GCJ capsules were administered orally 3 times a day. Results: The median follow-up was 13.4 months, and 25 (55.6%) patients showed disease-related events. Hyperthermia with GCJ treatment was administered in combination group (n = 36, 66.7%) and traditional Korean medicine-only group (n = 17, 31.5%). The median EFS was 190 days, and the median OS was 390 days. The group of hyperthermia 7 times or fewer and GCJ more than 28 days showed longer EFS and OS. The analysis of superiority between hyperthermia and GCJ showed no significant difference (EFS, P = .55; OS, P = .364). Conclusions: The combination of hyperthermia 1 to 2 times a week with GCJ treatment may improve survival of cancer patients treated or being treated with conventional cancer therapies.
Collapse
Affiliation(s)
- Hyeong Joon Jun
- Seoul Korean Medicine Hospital of
Daejeon University, Seoul, Republic of Korea
| | - So-Jung Park
- Dunsan Korean Medicine Hospital of
Daejeon University, Daejeon, Republic of Korea
| | - Hwi-Joong Kang
- Seoul Korean Medicine Hospital of
Daejeon University, Seoul, Republic of Korea
| | - Ga-Young Lee
- Cheonan Korean Medicine Hospital of
Daejeon University, Cheonan, Republic of Korea
| | - Namhun Lee
- Cheonan Korean Medicine Hospital of
Daejeon University, Cheonan, Republic of Korea
| | - Ji Hye Park
- Seoul Korean Medicine Hospital of
Daejeon University, Seoul, Republic of Korea
| | - Hwa-Seung Yoo
- Seoul Korean Medicine Hospital of
Daejeon University, Seoul, Republic of Korea
| |
Collapse
|
14
|
Role of Simulations in the Treatment Planning of Radiofrequency Hyperthermia Therapy in Clinics. JOURNAL OF ONCOLOGY 2019; 2019:9685476. [PMID: 31558904 PMCID: PMC6735211 DOI: 10.1155/2019/9685476] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/20/2019] [Accepted: 07/28/2019] [Indexed: 12/26/2022]
Abstract
Hyperthermia therapy is a treatment modality in which tumor temperatures are elevated to higher temperatures to cause damage to cancerous tissues. Numerical simulations are integral in the development of hyperthermia treatment systems and in clinical treatment planning. In this study, simulations in radiofrequency hyperthermia therapy are reviewed in terms of their technical development and clinical aspects for effective clinical use. This review offers an overview of mathematical models and the importance of tissue properties; locoregional mild hyperthermia therapy, including phantom and realistic human anatomy models; phase array systems; tissue damage; thermal dose analysis; and thermoradiotherapy planning. This review details the improvements in numerical approaches in treatment planning and their application for effective clinical use. Furthermore, the modeling of thermoradiotherapy planning, which can be integrated with radiotherapy to provide combined hyperthermia and radiotherapy treatment planning strategies, are also discussed. This review may contribute to the effective development of thermoradiotherapy planning in clinics.
Collapse
|