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Blood flow and oxygenation status of human tumors

Durchblutungs- und Oxygenierungsstatus von Tumoren beim Menschen. Klinische Untersuchungen

Clinical investigations

  • Published:
Coloproctology Aims and scope

Abstract

There is a large body of evidence suggesting that blood flow and oxygenation of human tumors are important research topics which may explain, in particular, resistance to radiation to many antineoplastic drugs, which can limit the curability of solid tumors by radiotherapy and chemotherapy. This manuscirpt reviews the clinical investigations which have been performed regarding blood flow and oxygenation status of human tumors in radiation oncology.

The possible uses and limitations of the prognostic significance and the changes under therapy measuring blood flow and oxygenation in human tumors were discussed. In addition several aproaches were summarized, which can improve the microvascular O2 availability and perfusion-limited O2 delivery. The clinical data concerning the prognostic significance of blood flow, vascular function and oxygenation of human tumors are relevant for patient selection in clinical oncology. Strategies to improve traditional cancer therapy by modulation of the oxygenation status remain quite promising but more critical research and sophisticated clinical studies are necessary before its true potential is known.

Zusammenfassung

Das Tumormikromilieu ist ein wesentlicher Faktor, der das Ansprechen von Tumoren auf konservative Behandlungsverfahren und damit die Heilungschancen gegenüber Strahlen- und/oder Chemotherapie bestimmt. Die folgende Übersicht greift die wichtigsten Parameter des Mikromilieus, die in der klinischen Strahlentherapie untersucht wurden, auf: die Tumorvaskularisierung, Tumordurchblutung und die Oxygenierung solider Tumoren.

Die klinischen Messungen zur Durchblutung und Tumoroxygenierung werden prätherapeutisch sowie im Verlauf unter Strahlentherapie zusammenfassend dargestellt und ihre prognostische Wertigkeit diskutiert. Darüber hinaus wird auf klinische Versuche eingegangen, die zu einer Verbesserung des intravaskulären Sauerstoffgehalts sowie einer Verbesserung der Mikrozirkulation führen und damit die diffusions- und perfusionslimitierte Sauerstoffverfügbarkeit überwinden können. Die klinischen Ergebnisse zur prognostischen Bedeutung von Tumordurchblutung und Oxygenierung werden zukünftig für die Selektion von Patienten und die Individualisierung der Tumotherapie von Bedeutung sein. Ansätze, die Therapieergebnisse konventioneller Verfahren durch beeinflussung der Tumoroxygenierung zu verbessern, sind vielversprechend, müssen allerdings im Rahmen systematischer klinischer Studien geprüft werden.

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  1. Klinik und Poliklinik für Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar der Technischen Universität, Ismaninger Straße 22, D-81675, München

    Horst J. Feldmann & Michael Molls

  2. Institut für Physiologie und Pathophysiologie der Universität Mainz, Mainz, Deutschland

    Peter Vaupel

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  1. Horst J. Feldmann
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  2. Michael Molls
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Feldmann, H.J., Molls, M. & Vaupel, P. Blood flow and oxygenation status of human tumors. Coloproctol 21, 57–69 (1999). https://doi.org/10.1007/BF03044653

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