Physics and Technology of Hyperthermia PDF
Preview Physics and Technology of Hyperthermia
Physics and Technology of Hyperthermia NATO ASI Series Advanced Science Institutes series A Series presenting the results ofactivities sponsored by the NATO Science Committee, which aims at the dissemination ofadvancedscientificand technological knowledge, with a view to strengthening links between scientific communities. The Series is published by an international board of publishers in conjunction with the NATO Scientific Affairs Division A Life Sciences Plenum Publishing Corporation B Physics London and New York C Mathematical and D. Reidel Publishing Company Physical Sciences Dordrecht, Boston, Lancaster and Tokyo D Behavioural and Martinus Nijhoff Publishers Social Sciences Boston, Dordrecht and Lancaster E Applied Sciences F Computer and Springer-Verlag Systems Sciences Berlin, Heidelberg, New York G Ecological Sciences London, Paris, Tokyo H Cell Biology Series E: Applied Sciences - No. 127 Physics and Technology of Hyperthermia edited by Stanley B. Field MRC Cyclotron Unit Hammersmith Hospital Ducane Road London W12 OHS U.K. Cafiero Franconi Medical Physics Institute II University of Rome Via O. Raimondo 00173 Rome Italy 1987 Martinus Nijhoff Publishers Dordrecht / Boslon / Lancaster Published in cooperation with NATO Scientific Affairs Division Proceedings of the NATO Advanced Study Institute on "Physics and Technology of Hyperthermia", Urbina, Italy, July 26-August 9, 1986 ISBN-13:978-94-010-8109-2 e-ISBN-13: 978-94-009-3597-6 DOl: 10.1007/978-94-009-3597-6 Distributors for the United States and Canada: Kluwer Academic Publishers, P.O. Box 358, Accord-Station, Hingham, MA 02018-0358, USA Distributors for the UK and Ireland: Kluwer Academic Publishers, MTP Press Ltd, Falcon House, Queen Square, Lancaster LA11AN, UK Distributors for all other countries: Kluwer Academic Publishers Group, Distribution Center, P.O. Box 322, 3300 AH Dordrecht, The Netherlands All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publishers, Martinus Nijhoff Publishers, P.O. Box 163, 3300 AD Dordrecht, The Netherlands Copyright © 1987 by Martinus Nijhoff Publishers, Dordrecht Softcoverreprintofthehardcover1stedition 1987 v TABLE OF CONTENTS Foreword IX List of Lecturers XI SECTION I - LECTURERS' CHAPTERS 1. Problems in Cancer Treatment E J Maher 3 19 2. Biological Aspects of Hyperthermia S B Field 3. Biological Basis for Rational Design of Clinical Treatment with Combined Hyperthermia and Radiation 54 J Overgaard, 0 S Nielsen and J C Lindegaard 4. Hyperthermia Heating Technology and Devices 80 CFranconi 5. Electromagnetic Field Generation and Propagation CHDurney 123 6. Calculation of Electromagnetic Power Deposition CHDurney 152 7. Electromagnetic Power Deposition: Inhomogeneous Media. Applicators and Phased Arrays J Bach Andersen 159 8. Electromagnetic Applicators for Non-invasive Local Hyperthermia 189 J WHand 9. Interstitial Techniques for Hyperthermia J WStrohbehn 211 10. Electromagnetic Regional Heating CHDurney 240 11. Radiofrequency Power Sources for Hyperthermia KVEttinger 250 12. Phantoms for Electromagnetic Heating Studies C-K Chou 294 13. Biological Effects of Electromagnetic Waves C-K Chou 319 14. Principles of Ultrasound Used for Hyperthermia J WHunt 354 15. Ultrasonic Heating Techniques RB Roemer 390 16. Ultrasound Phantoms/Animals Experiments RB Roemer 403 VI 17. Laboratory Techniques for Heating Experimental Animals J WHand 414 18. Whole Body Hyperthermia as a Treatment Modality J van der Zee, NS Faithfull, GCvan Rhoon and HS Reinhold 420 19. Blood Flow GMHahn 441 20. Tumour Microcirculation HS Reinhold 448 21. Effects of Hyperthermia on Tumour Microcirculation HS Reinhold 458 22. Thermometry T CCetas 470 23. Non-invasive Methods of Temperature Measurement GMHahn 509 24. Heat Transfer in Tissues J J WLagendijk 517 25. Thermal Models/Temperature Distributions RB Roemer 553 26. Treatment Planning and Evaluation RB Roemer 562 27. The Combination of Heat and Radiation in cancer Treatment GArcangeli, ACividalli, GLovisolo and F Mauro 574 28. The Role of Hyperthermic Perfusion in Treating Limb Tumors: Our Experience at Regina Elena Cancer Institute F di Filippo, RCavaliere, S Carlini, AHCalabro, L Piarulli, F Moscarelli, F Cavaliere, GZupi and CGreco 586 29. The Design of Clinical Trials in Hyperthermic Oncology J Overgaard 598 SECTION II - DISCUSSION REPORTS 1. Principles of Cancer Therapy and Clinical Trials 623 J Maher 2. Thermobiology and Physiology 626 HS Reinhold 3. Calculation of Electromagnetic Power Deposition C HDurney 628 4. EM Hazards; Protection of Patients and Operators; EM Field Dosimetry C-K Chou 630 5. Safety and Quality Control Panel GMHahn 632 6. Heating Tumours in Small Animals BMondovi 634 VII 7. New Approaches to Hyperthermia Systems J WStrohbehn 636 8. Ultrasound Hyperthermia J WHunt 639 9. Temperature Measurements and Dosimetry T C Cetas 641 10. From the Hyperthermia Laboratory to the Treatment Room J Lagendijk 644 11. Which Hyperthermia System? ASurvey of Methods, Equipment and Problems CFranconi 647 Subject Index 653 IX FOREWORD In the 1960s a firm rationale was developed for using raised temperatures to treat malignant disease and there has been a continuous expansion of the field ever since. However, a major limitation exists in our ability to heat human tumours, especially those sited deep in the body, with a reasonable degree of temperature uniformity. This problem has resulted in engineers and physicists collaborating closely with biologists and clinicians towards the common goal of developing and testing the clinical potential of this exciting treatment modality. The aim of the physicist and engineer is to develop acceptible methods of heating tumQur masses in as many sites as possible to therapeutic temperatures avoiding excessive heating of normal structures and, at the same time, obtaining the temperature distribution throughout the heated volume. The problem is magnified by both the theoretical and technical limitations of heating methods and devices. Moreover, the modelling of external deposition of energy in tissue and knowledge of tissue perfusion are ill-defined. To this must be added the conceptual difficulty of defining a thermal dose. The NATO course was designed to provide a basis for the integration of physics and technology relevant to the development of hyperthermia. There were 48 lectures covering the theoretical and practical aspects of system design and assessment, including, as far as possible, all the techniques of current interest and importance in the field. The fundamental concepts of the relevant biology and physiology were included and some of the clinical findings and problems were summarised. There were 11 panel discussions on selected topics, each summarised in the text by a raporteur. In this volume the whole Course is represented in the 29 lecturers' chapters together with the raporteurs' reports. The School was made possible by a substantial grant from the Scientific Affairs Division of NATO and we are also grateful for support from the Consiglio Nazionale delle Ricerche, to ENEA and to the International Centre for Theoretical Physics, Trieste. The ASI was held in the beautiful city of Urbino and we thank the University of Urbino and the ERSU for making it possible together with the excellent organisation of the Collegio. We express our appreciation to the Scientific Advisory Committee, J Bach Andersen, T Cetas, J WHand, J Oleson, J Overgaard and H Reinhold for advice on the programme and to all lecturers who together represent a substantial majority of those who have made significant contributions to this field during the last two decades. We are indebted to C A Tiberio and Giovanna Franconi for much of the organisation of the Course, greatly helped by Germana Banci, Luisa Begnozzi, Matilde Nardi, Luigi Raganella and Laila Wilby. Finally, we thank our participants, who came from 26 nations, for their questions and contributions which made this ASI stimUlating and successful. Cafiero Franconi Stanley B Field November 1986 XI LECTURERS Giorgio Arcangeli Istituto Medico e di Ricerca Scientifica Italy Jorgen Bach Andersen University of Aalborg Denmark Thomas CCetas University of Arizona Health center USA C-K Chou City of Hope National Medical Center USA Franco di Filippo Regina Elena Cancer Institute Italy Carl HDurney University of Utah USA Kamil VErtinger 2nd University of Rome Italy Stanley 8 Field HRC Cyclotron Unit United KingdOlll Cafiero Franconi 2nd University of Rome Italy George HHahn Stanford University USA Jeffrey WHand HRC Cyclotron Unit United KingdOlll John WHunt Ontario Cancer Institute Canada Jan J WLagendijk University Hospital The Netherlands Jane Maher Royal Marsden Hospital United KingdOlll XII Jens Overgaard Institute of Cancer Research Demnark HS Reinhold Radiobiological Institute TNO The Netherlands Robert B Roemer University of Arizona USA John WStrohbehn Dartmouth College USA
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