Читать книгу Intracranial Gliomas Part III - Innovative Treatment Modalities - Группа авторов - Страница 33

In cases of gliomas local hyperthermia has proved to have an optimal therapeutic effect in a window between 41 and 45°C [11]. Within this range, neoplastic cells seem to be more sensitive to heat than normal ones, probably due to intratumoral hypoxia, acidosis, and nutritional deprivation [12]. Studies on animal models have demonstrated that biological tissues exposed to a thermal equivalent of ≥43°C for ≥60 min undergo apoptosis and die within 48 h, whereas shorter treatment results in lesser damage, which may be either fatal or not, depending on a multitude of physiological factors [13]. There is an evidence that hyperthermia also leads to infiltration of the targeted tissue by T lymphocytes and macrophages, stimulating a local immunological response [14]. Abnormal neoplastic microvasculature has increased susceptibility to heat [12], and there is some evidence that laser energy opens the blood-brain barrier (BBB) for a defined time interval of several hours [15, 16]. Finally, it was demonstrated in an experimental study that hyperthermia potentiates the effects of both ionizing irradiation and chemotherapy [17]. Of note, temperatures >45°C will inevitably lead to protein coagulation in all cells within the target tissue volume [11].