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Clinical measurement and modulation of microregional tumour blood flow

Powell, Melanie E. B.; (1998) Clinical measurement and modulation of microregional tumour blood flow. Doctoral thesis (M.D), UCL (University College London). Green open access

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Modification of the tumour microenvironment by improving tumour blood flow and oxygenation may be a method of enhancing cure rates. Pre-clinical studies have shown the combination of carbogen and nicotinamide can effectively radiosensitize, however, the mechanism of action for this remains unclear. Carbogen enhances tumour oxygenation primarily by increasing the amount of oxygen dissolved in blood. Animal studies suggest it may also improve tumour blood flow. In murine tumours nicotinamide reduces the occurrence of temporal fluctuations in blood flow. Commercially available laser Doppler microprobes have now made possible the direct real-time measurement of erythrocyte flux in human tumours, allowing the influence of carbogen and nicotinamide on microregional blood flow to be assessed. Red blood cell flux was measured using the Oxford Array multiple channel laser Doppler system (Oxford Optronix, Oxford, UK). Measurements were taken for 60 minutes in thirteen patients (control group), eight also breathed carbogen for 10 minutes. A further ten patients were pre-treated with nicotinamide prior to carbogen. Fluctuations in erythrocyte flux were a common event, 62% of sampled areas showed a change of 1.5 fold or more. Both increases and decreases were seen. Carbogen caused small, tumour dependent changes in flux with both increases and decreases. Nicotinamide did not significantly alter changes in microregional blood flow but when combined with carbogen an overall increase in flux of 22% was seen, with all but one tumour showing an increase. The improvement in microregional perfusion seen with the combination of carbogen and nicotinamide could have important clinical implications for both radiotherapy and the delivery of systemic agents.

Type: Thesis (Doctoral)
Qualification: M.D
Title: Clinical measurement and modulation of microregional tumour blood flow
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
Keywords: Health and environmental sciences; Blood flow; Tumor oxygenation
URI: https://discovery.ucl.ac.uk/id/eprint/10104284
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