Toshiko Shiga

Enhancement of thermoradiotherapy by glucose administration for superficial malignant tumours

The effect of hyperglycemia on the thermoradiotherapy of superficial malignant tumours was investigated. Glucose administration alone (500 ml of 10% glucose by intravenous drip infusion) reduced the tumour blood flow, when measured by laser Doppler flowmetry, to 66.1% of the baseline level at 30 minutes after the beginning of glucose infusion. Forty patients received glucose in tandem during the hyperthermia and radiotherapy (group A), and 38 patients received thermoradiotherapy alone (group B). The mean Tave (the average temperature of all intratumoural sensors) in group A was 43.4 +/- 1.1 degrees C while that in group B was 42.5 +/- 1.2 degrees C, i.e., glucose administrations significantly increased the tumour temperature (p < 0.01). In group A, complete tumour response (CR) was observed in 12 patients (30.0%), partial response (PR) in 25 patients (62.5%) and no response (NR) in three patients (7.5%). In group B, seven (18.4%), 20 (52.7%) and 11 (28.9%) patients showed CR, PR and NR, respectively. The tumour response rates were significantly different between two treatment groups (p < 0.05). The frequency of side effects of hyperthermia in groups A and B were 22.5 and 21.1%, respectively. This study suggests that hyperglycemia enhances the effectiveness of thermoradiotherapy.

Apolipoprotein C-II is a potential serum biomarker as a prognostic factor of locally advanced cervical cancer after chemoradiation therapy.

PURPOSE To determine pretreatment serum protein levels for generally applicable measurement to predict chemoradiation treatment outcomes in patients with locally advanced squamous cell cervical carcinoma (CC). METHODS AND MATERIALS In a screening study, measurements were conducted twice. At first, 6 serum samples from CC patients (3 with no evidence of disease [NED] and 3 with cancer-caused death [CD]) and 2 from healthy controls were tested. Next, 12 serum samples from different CC patients (8 NED, 4 CD) and 4 from healthy controls were examined. Subsequently, 28 different CC patients (18 NED, 10 CD) and 9 controls were analyzed in the validation study. Protein chips were treated with the sample sera, and the serum protein pattern was detected by surface-enhanced laser desorption and ionization-time-of-flight mass spectrometry (SELDI-TOF MS). Then, single MS-based peptide mass fingerprinting (PMF) and tandem MS (MS/MS)-based peptide/protein identification methods, were used to identify protein corresponding to the detected peak. And then, turbidimetric assay was used to measure the levels of a protein that indicated the best match with this peptide peak. RESULTS The same peak 8918 m/z was identified in both screening studies. Neither the screening study nor the validation study had significant differences in the appearance of this peak in the controls and NED. However, the intensity of the peak in CD was significantly lower than that of controls and NED in both pilot studies (P=.02, P=.04) and validation study (P=.01, P=.001). The protein indicated the best match with this peptide peak at 8918 m/z was identified as apolipoprotein C-II (ApoC-II) using PMF and MS/MS methods. Turbidimetric assay showed that the mean serum levels of ApoC-II tended to decrease in CD group when compared with NED group (P=.078). CONCLUSION ApoC-II could be used as a biomarker for detection in predicting and estimating the radiation treatment outcome of patients with CC.

Relevance of a New Impedance Matching, or Subtrap, Method for the Reduction of Pain During Hyperthermia

Capacitive heating is widely used in hyperthermic treatment of human malignancies. However, the pain on the body surface or thermoesthesia in the subcutaneous fatty layer may prevent an elevation of temperature in the tumors. Impedance matching is improved by a subtrap method entailing the application of two copper plates (10 x 850 x 0.06 mm) as a subtrap circuit to each of two capacitive electrodes. In a clinical trial the Tmax, Tave, Tmin for the subtrap method were all higher in comparison with those for the conventional technique (42.5 +/- 0.7 degrees C, 41.9 +/- 1.0 degrees C, 41.3 +/- 1.1 degrees C vs. 41.1 +/- 1.5 degrees C, 40.6 +/- 1.3 degrees C, 40.0 +/- 1.3 degrees C). Although the maximal radiofrequency (RF) power applied to patients was higher with the subtrap method (875 +/- 189 W vs. 763 +/- 200 W), the incidence of surface pain was reduced dramatically. It is concluded that the subtrap method substantially improves the RF capacitive heating of deep-seated tumors.

Dynamic computed tomography predicts tumor temperature and response to thermoradiotherapy in superficial and subsurface tumors.

Dynamic computed tomography (CT) was performed on patients undergoing thermoradiotherapy for superficial or subsurface tumors, and the correlation between tumor enhancement and tumor temperature during hyperthermia was evaluated. The authors further investigated whether tumor enhancement by dynamic CT is predictive of tumor response to thermoradiotherapy.