DE3611971A1 - Method and device for treating tumour tissue by heat, by means of interstitial micro heat exchangers inserted in the body - Google Patents

Abstract

In methods of the generic type, energy transport into the diseased tissue is effected via small-dimensioned tubes through which warm water flows. The heat transfer on the inside of the tubes is always higher than that on the outside of the tubes resting against the tissue, i.e. the limiting factor in the heat transfer system is outside the heat exchanger which ensures a maximum energy transfer coupled with a minimum temperature of the tube walls. Through the interstitial heat exchangers there flows water or a mixture of water and alcohol maintained at 45-60 degrees centigrade by a precision thermostat. The heat exchangers can be implanted as a single tube by the perforation method and as a coaxial tube by the puncture method. The heat exchanger tubes and the connecting system are dimensioned such that they can also be used as carriers for radioactive products in the patient without any alteration. For microwave therapy, the same system can be used for cooling the antennas inserted in the body.

Description

Method and device for treating tumor tissues with heat, through interstitial micro heat exchangers used in the body.

In human medicine, che is used to treat malignant cell groups mix and physical processes (methods) to an increased extent Success applied.

In particular, high chances of recovery are expected if, in addition to one chemical treatment the various possible physical treatments lungs (heat, X - rays or gamma rays) wherever possible and at the same time, but at least in the same location and in direct time Sequence of process steps take place. Therefore, in addition to the extracorporeal procedures those intracorporeal procedures greater opportunities conceded, where heat and radiation treatment with one and the same Implant can be performed.

In the known extracorporeal processes, the water in the tissue is passed through Electromagnetic fields are supplied with energy and converted into heat. In Another method uses ultrasound and converted into heat by molecular friction.

The extracorporeal processes have an extraordinarily high tech African effort the disadvantage that in addition to the treated body zones in part healthy tissue is also heated, which is certainly an adverse side effect triggers.

In the known intracorporeal processes described in the literature antennas are inserted into the body. The between these antennas acting electromagnetic fields heat the tissue locally. In one further processes use ferromagnetic implants, the Heat is generated by hysteresis losses in the implants intracorporeally, the primary energy but extracorporeal through alternating electromagnetic fields - without affecting healthy tissue.

These systems have been described u. a. in the following works:

• A: Author: Friedenthal E, Mendecki J Title: Experience with clinical hyperthemia at Montefiore Medical Center - Albert Einstein College of medicine (meeting abstract) Institute: International Clinical Hyperthermia Society American Clinical Hyperthermia Meeting. December 5-8, 1984 Palm Springs, California, 1984  
• B: Author: Bicher HI, Wolfstein RS, Fingerhut AG Lewinsky BS, Frey HS, Metcalf DR, Copps D Title: Interstitial and Custom Thermoradiotherapy- Preliminary Clinical Results (Meeting Abstract) Institute: International Clinical Hyperthermia Society, American Clinical Hyperthermia Meeting. December 5-8, 1984 Palm Springs, California, 1984
• C: Author: Puthawala AA, Nisar Syed AM, Sheikh KM, Rafie S Title: Thermoendocurietherapy in the Treatment of Persistent and / or Recurrent Tumors (Meeting Abstract) Institute: International Clinical Hyperthermia Society American Clinical Hyperthermia Meeting. December 5-8, 1984 Palm Springs, California, 1984
• D: Author: Cosset JM, Dutriex J, Gerbaulet A, Damia E Title: Combined Interstitial Hyperthermia and Brachytherapy The Institute Gustave - Roussy Experience (Meeting Abstract) Institute: Hyperthermic Oncology. 4th International Symposium. July 2-6, 1984 Aarhus, Denmark, Abstract D 17, 1984
• E: Author: Ivan A. Brezovich, William J. Atkinson Title: Temperature distributions in tumor models heated by self-regulating nickel-copper alloy thermoseeds Institute: Department of Rediation Oncology, University of Alabama in Birmingham, Birmingham, Alabama 35,233, Dev P. Chakraborty Department of Diagnostic Radiology, University of Alabama in Birmingham, Birmingham, Alabama 35 233 (Received 17 June 1983, accepted for publication 26 October 1983)

The known intracorporeal methods are essentially two Factors limited: With the resistance-heated systems with internal heating hot and cold spots cannot be ruled out Use of the implants as antennas with a corresponding self-heating calculation. Both reduce or increase the effect of the therapy Treatment risk. In the inductive process is the energy transfer limited by system. As a rule, this leads to higher than implant temperatures corresponding to the optimal therapy must become.  

Technically in all these systems is because of the necessary individual Regulations to make a high effort of measurement and control technology.

The subject patent application is concerned with a process at the introduction of the thermal energy necessary for the treatment directly by means of micro heat exchangers used in the diseased tissue. As a pri mär energy source is water or a water-alcohol mixture with be agreed boiling behavior used. The micro heat exchanger consists of hollow needles or coaxial hollow needles with high heat transfer values.

Fig. 1A and Fig. 1B.

Fig. 1A shows a needle for puncture treatment,

Fig. 2B shows one for puncture treatment.

The needle system can be supplied with hot water via a pressure or suction system. The expected heat transfer value for the printing system is around 3000 to 4000 kcal / m ² . degrees in the suction system about 8000 to 10,000 kcal / m ² . degrees ( Fig. 2A and Fig. 2B).

With the proposed system, energy transfer services can be achieved chen, exclusively by the heat transfer factor of the needle surface are intended for tissue. Because of the high possible energy transfer rate the needle temperature can be kept at the lowest possible value or high amounts of heat with the smallest temperature difference which are inserted into the tissue between the needle and the tissue. As well parts of tissue that are heavily or heavily flowed through by blood at constant Needle temperature still be adequately supplied with energy.

Another major advantage of this method is that place the individual rules necessary with the conventional methods lungs a simple, exclusively based on the water temperature, collective regulation is required.

With this method, all conventional needle systems can be used for the puncture system (corresponding to Fig. 1A), which are also used for the treatment with radioactive implants.

The disadvantage of these needles, in which the energy transfer would take place over the entire length of the needle, is compensated for by covering those areas which lie outside the tumor zones with an insulating layer of a certain thickness (analogous to item 4, Fig. 3).

About 30-40% of all tumors are only accessible on one side and can therefore not be treated with conventional needle systems. With these For tumors, the needle must be inserted on one side.  

This needle consists of a coaxial arrangement of two thin-walled steel tubes ( Fig. 3, items 1 and 2).

The inflow and outflow of the heating water is carried out by a corresponding Na dolphin. (Item 3). This type of needle is also used to protect the healthy Tissue of the part of the needle adjoining the head with an insulating layer provided (item 4).

The water is supplied via the inner tube, the cross section of the inside tube is smaller than the ring cross-section of the inner and outer tube. This ensures a pressure distribution in suction mode, which in the ring room holds the liquid heating medium at the evaporation limit.

The guidance and sealing of the coaxial needle system is accomplished in that two sikken arranged on the outer tube, the inner diameter of which corresponds to the outer diameter of the inner tube, perform this function ( Fig. 4).

Another advantage of this construction is that it is cheaper to manufacture of the needle system that the system is assembled without twisting positioning can be.

The high heat transfer performance of the water-loaded needle systems shows also on the possible use in inductively heated systems. At the Flow of the needles with water of 37 ° C can arise in the antennas compensated inherent heat, d. H. the needles can be used regardless of their electrical power, body temperature or the desired treatment lung temperature are kept.

Claims (9)

Main claims: Process for the intracorporeal treatment of malignant cell groups by means of heat, characterized in that all heat carriers water, alcohol or water mixtures, preferably H ₂ O / C ₂ H ₅ OH mixtures, are used. The heat transfer performance of these systems for needles of 1.6 to 2.0 mm in diameter is at least in the order of 100 to 200 or 200 to 400 milliwatts per cm ^{2 of} needle length. The system is preferably used to heat tumor tissues (interstitial hyperthermia). Another application is use of the system as a cooling unit in inductively operated Systems. 1. Subclaim: In the process described in the main claim, who the preferably water or water - alcohol - Ge mix uses that also use these devices enable in sterile rooms. 2. Subclaim: The composition of the heating medium and the pressure in the Needle systems are chosen so that in suction mode the pressure in the inner tube above and in the annulus between Inner and outer tube is below the boiling pressure. 3. Subclaim: The process is characterized in that in tracorporal temperature measurement to control the tem temperature or energy transfer can. The treatment temperature and the energy transfer are only on the thermostat and by the Operating pressure of the water supply system poses. 4. dependent claim: method, characterized in that due to the used heat transfer medium and the resulting Energy transfers the excess temperature in the tissue  lowers and near the optimal treatment temperature can be brought. 5. Sub-claim: Method, characterized in that the Nadelbe pass the outside of the tissue zone to be treated are provided with an insulating layer that the heat transfer at this point by a 10er Po reduced to 10-20 mW / cm. 6. Subclaim: The needle systems for one-sided application are sealed by a metal to metal seal. This sealing system also takes over the exak guidance of the inner needle.