Academic literature on the topic 'Minimal invasive cancer treatment'

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Journal articles on the topic "Minimal invasive cancer treatment"

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Buess, G., B. Mentges, K. Manncke, M. Starlinger, and H. D. Becker. "Minimal invasive surgery in the local treatment of rectal cancer." International Journal of Colorectal Disease 6, no. 2 (May 1991): 77–81. http://dx.doi.org/10.1007/bf00300195.

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Albers, P., S. Schaefers, H. Löhmer, and P. De Geeter. "Minimal invasive perineal radical prostatectomy." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 15566. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.15566.

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15566 Background: Radical perineal prostatectomy (RPP) has experienced a reappraisal as excellent surgical treatment option for patients with localized prostate cancer which is competing well with the retropubic (RRP), endoscopic and robotic approaches. Herein we report a new and improved minimal invasive technique of an intrafascial, nerve-sparing and seminal vesical sparing RPP. Methods: From July 2003 to July 2006, 507 radical prostatectomies (317 RPP, 190 RRP) have been performed by 3 surgeons. RPP selection criteria: PSA ≤ 10 ng/ml, Gleason sum ≤ 7, volume ≤ 50 ml. A minimal invasive technique (MI-RPP) was used in 146 of 317 RPP (46%) in order to potentially improve on the results of classical RPP. “Minimal invasive” was defined as an approach with reduced mobilisation of the rectum, intended bilateral nerve-sparing with intrafascial preparation and leaving the seminal vesicals in situ. This approach was compared to classical RPP and to RRP. Perioperative and follow-up data using validated questionnaires were centrally registered using an on-line internet-based prostate cancer data bank provided by the Tumorzentrum Berlin. Results: With a median follow-up of 12 months (0–24), the oncological outcome of patients with MI-RPP was not different to RPP or RRP (comparable T-stages). PSA relapse in MI-RPP, RPP, and RRP in pT2R0 was seen in 10.2%, 14.7%, and 9.7% respectively (n.s.). Continence rates (0–1 pad/d) at 4 weeks were 61.7%, 45.0%, and 43.8%, respectively. This improved at 12 months to 96.3%, 85.7%, and 85.6%, respectively (p < 0,023; p < 0,005). MI-RPP, RPP, and RRP showed pT2 in 70.5, 69.6, and 57.3% with R1pT2 in 1.9, 6.7, and 9.2%, resp. Nerve-sparing was performed in 90.4, 62.0, and 57.4% with median OR times of 90, 141, and 163 min. Catheter removal after more than 13 d was seen in 6.6, 13.6, and 33.3%, resp. Conclusions: MI-RPP represents an improved perineal technique regarding intraoperative and postoperative complications maintaining comparable oncological outcome to RPP and RRP. Leaving seminal vesicals in place did not increase PSA relapse rates. Since OR time is significantly less and early recovery is superior, MI-RPP should be the recommended first-line perineal approach to patients with low risk prostate cancer. At the time of the meeting, data of more than 600 patients will be presented. No significant financial relationships to disclose.
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Ghadyalpatil, Nikhil Suresh, Chopra Supriya, Patil Prachi, Dsouza Ashwin, and Saklani Avanish. "Gastrointestinal cancers in India: Treatment perspective." South Asian Journal of Cancer 05, no. 03 (July 2016): 126–36. http://dx.doi.org/10.4103/2278-330x.187585.

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AbstractGI cancer is not one cancer but is a term for the group of cancers that affect the digestive system including gastric cancer (GC), colorectal cancer (CRC), hepatocellular carcinoma (HCC), esophageal cancer (EC), and pancreatic cancer (PC). Overall, the GI cancers are responsible for more cancers and more deaths from cancer than any other organ. 5 year survival of these cancers remains low compared to western world. Unlike the rest of the world where organ based specialities hepatobiliary, pancreatic, colorectal and esophagogastric exist , these cancers are managed in India by either a gastrointestinal surgeons, surgical oncologist, or a general surgeon with varying outcomes.The aim of this review was to collate data on GI cancers in indian continent. In colorectal cancers, data from tertiary care centres identifies the unique problem of mucinous and signet colorectal cancer. Results of rectal cancer resection in terms of technique (intersphincteric resection, extralevator aper, minimal invasive approach ) to be comparable with world literature. However long term outcome and data regarding colon cancers and nationally is needed. Gastric cancer at presentation are advanced and in surgically resected patients, there is need for a trial to compare chemoradiation vs chemotherapy alone to prevent loco regional recurrence. Data on minimal invasive gastric cancer surgery may be sparse for the same reason. Theree is a lot of data on surgical techniques and perioperatve outcomes in pancreatic cancer. There is a high volume of locally advanced gallbladder cancers with efforts on to decide whether neoadjuvant chemotherapy or neoadjuvant chemoradiotherapy is better for down staging. Considering GI cancers, a heterogeneous disease with site specific treatment options and variable outcomes, the overall data and outcomes are extremely variable. Young patients with pathology unique to the Indian subcontinent (for example, signet ring rectal cancer, GBCs) need focussed attention. Solution for such pathology needs to come from the Indian continent itself. Joint efforts to improve outcomes for GI cancer can be integrated under the national cancer grid program.
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Uchikado, Yasuto, Itaru Omoto, Ken Sasaki, Hiroshi Okumura, Yoshiaki Kita, Tetsuhiro Owaki, Yusaku Osako, et al. "PS01.222: HAS A MEDIASTINOSCOPE-ASSISTED ESOPHAGECTOMY CONTRIBUTE TO CURABILITY AND MINIMAL INVASIVE SURGERY?" Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 113. http://dx.doi.org/10.1093/dote/doy089.ps01.222.

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Abstract Background In a mediastinoscope-assisted esophagectomy, it is unknown whether it contributes to minimally invasive surgery or curability. We examined the outcome of treatment of a mediastinoscope-assisted esophagectomy performed in our hospital. Methods From June 2014 to October 2017, 31 patients underwent a mediastinoscope-assisted esophagectomy. The examined items were clinicopathological factors, preoperative complications, preoperative treatment, bleeding volume, operation time, postoperative complications, and recurrence. Results There were 29 males, 2 females, and the average age 66 years. As preoperative treatment, 12 nontreatment, 4 chemotherapies, and 15 chemoradiotherapy (CRT) were performed. Preoperative complications were found in 27 cases, among which 13 cases were respiratory complications. The percentage of double cancers was also high, 8 cases with synchronous cancer, and 6 cases with metachronous cancer. Gastric cancer accounted for half in synchronous cancer, and in metachronous lung cancer was 4 cases. The reconstructed organs were 29 cases of stomach tube and 2 cases of colon. The reconstruction route was 17 cases in front of the chest wall and the chest wall anterior route was selected for the case of preoperative CRT significantly. The average bleeding volume was 316 ml, and the average operation time was 560 minutes. Pathological tumor depth T0/1a/1b/2/3 were each 2/11/6/7/4 cases. In the postoperative complications, 12 cases of temporary recurrent nephropathy, 5 cases of anastomotic suture failure, 3 cases of pulmonary complications. There were 6 cases (19.3%) of recurrence. Postoperative recurrence was associated with significant pathological tumor depth. Conclusion A mediastinoscope-assisted esophagectomy decreased postoperative pulmonary complications and there were not many recurrences after surgery. It seemed to contribute to minimally invasive surgery and curability. Disclosure All authors have declared no conflicts of interest.
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Nguyen, Thuy Trang, Thi Thuy Dung Nguyen, Qui Thanh Hoai Ta, and Van Giau Vo. "Advances in non and minimal-invasive transcutaneous delivery of immunotherapy for cancer treatment." Biomedicine & Pharmacotherapy 131 (November 2020): 110753. http://dx.doi.org/10.1016/j.biopha.2020.110753.

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Raoof, Mustafa, and Steven A. Curley. "Non-Invasive Radiofrequency-Induced Targeted Hyperthermia for the Treatment of Hepatocellular Carcinoma." International Journal of Hepatology 2011 (2011): 1–6. http://dx.doi.org/10.4061/2011/676957.

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Targeted biological therapies for hepatocellular cancer have shown minimal improvements in median survival. Multiple pathways to oncogenesis leading to rapid development of resistance to such therapies is a concern. Non-invasive radiofrequency field-induced targeted hyperthermia using nanoparticles is a radical departure from conventional modalities. In this paper we underscore the need for innovative strategies for the treatment of hepatocellular cancer, describe the central paradigm of targeted hyperthermia using non-invasive electromagnetic energy, review the process of characterization and modification of nanoparticles for the task, and summarize data from cell-based and animal-based models of hepatocellular cancer treated with non-invasive RF energy. Finally, future strategies and challenges in bringing this modality from bench to clinic are discussed.
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Haga, Norihiro, Toru Ishiguro, Kouki Kuwabara, Kensuke Kumamoto, Youichi Kumagai, Hiroyuki Baba, Keiichiro Ishibashi, and Hideyuki Ishida. "Comparison of Three Different Minimally Invasive Procedures of Distal Gastrectomy for Nonoverweight Patients with T1N0-1 Gastric Cancer." International Surgery 98, no. 3 (August 1, 2013): 259–65. http://dx.doi.org/10.9738/intsurg-d-12-00028.1.

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Abstract Laparoscopic-assisted distal gastrectomy has recently come to be a standard procedure for the treatment of early gastric cancer1–5 in select patients. The minimal invasiveness associated with laparoscopic procedures for the resection of gastrointestinal cancer has been repeatedly explained in part by the short incision that is required.6–11 We used two different approaches to perform distal gastrectomies for the resection of gastric cancer as minimally invasive alternatives to a standard laparoscopic approach prior to our surgical team's complete mastery of the skills required for laparoscopic oncological surgery for gastric cancer.9,12 If the minimal invasiveness associated with laparoscopic-assisted gastrectomy can be explained by the small incision, a gastrectomy via a small incision without the use of a pneumoperitoneum may provide a similar outcome in patients. However, to our knowledge, such a comparison has not been previously made. We compared the minimal invasiveness of three different approaches (minilaparotomy, minilaparotomy approach with laparoscopic assistance, and standard laparoscopic-assisted approach) to performing a distal gastrectomy for T1N0-1 gastric cancer in nonoverweight patients (body mass index, ≤25 kg/m2) performed within a limited study period.
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Beets, G. L., L. A. Heijnen, M. Maas, M. H. Martens, D. M. J. Lambregts, R. G. H. Beets-Tan, and J. W. A. Leijtens. "77. Minimal invasive treatment for clinical complete and good responders after chemoradiation for rectal cancer." European Journal of Surgical Oncology 38, no. 9 (September 2012): 755. http://dx.doi.org/10.1016/j.ejso.2012.06.076.

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Peek, M., M. Ahmed, B. Haken ten, and M. Douek. "200. A systematic review of minimal invasive ablative techniques in the treatment of breast cancer." European Journal of Surgical Oncology (EJSO) 40, no. 11 (November 2014): S85. http://dx.doi.org/10.1016/j.ejso.2014.08.195.

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Gennari, Paolo, Michael Gerken, József Mészáros, Monika Klinkhammer-Schalke, Olaf Ortmann, Holm Eggemann, and Atanas Ignatov. "Minimal-invasive or open approach for surgery of early cervical cancer: the treatment center matters." Archives of Gynecology and Obstetrics 304, no. 2 (January 22, 2021): 503–10. http://dx.doi.org/10.1007/s00404-020-05947-y.

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Dissertations / Theses on the topic "Minimal invasive cancer treatment"

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Zachkani, Payam. "A minimally-invasive MEMS drug delivery device for the treatment of prostate cancer." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/51551.

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We have developed a cylindrical shape magnetically-actuated MEMS drug delivery device for localized prostate cancer treatment. The device is small enough for implantation through a needle with minimally invasive procedures with potentially fewer side effects compared with full prostate removal. This method of implantation will be similar to brachytherapy, a standard procedure to implant radioactive seeds inside the prostate through a needle. The drug delivery device consists of a drug reservoir, a PDMS membrane, a magnetic block and housing. Docetaxel (DTX), an anti-proliferative drug, is deposited in the reservoir in solid form. The reservoir is then filled with fluids to form a saturated drug solution. When an external magnetic field is applied, it attracts the magnetic block towards the positive field gradient and causes the membrane to deflect. As a result, DTX is discharged from the reservoir, through a laser-drilled aperture on the membrane and into the housing. The housing has a 10 mm long opening which allows the released drug to diffuse to the surrounding tissues while it would prevent the tissues from touching the thin membrane. We have achieved a 1.8 fold increase of the actuating distance and a 3.6 fold increase in the magnetic force compared to the state-of-the-art magnetically-actuated drug delivery devices under the same actuation parameters. We have also demonstrated device implantation with a needle into swine bladder tissue and successful drug release of the device in the tissue.
Applied Science, Faculty of
Mechanical Engineering, Department of
Graduate
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Garcia, Paulo A. "Irreversible Electroporation for the Treatment of Aggressive High-Grade Glioma." Diss., Virginia Tech, 2010. http://hdl.handle.net/10919/77269.

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Malignant gliomas (MG), most notably glioblastoma multiforme (GBM), are among the most aggressive of all malignancies. High-grade variants of this type of brain cancer are generally considered incurable with singular or multimodal therapies. Many patients with GBM die within one year of diagnosis, and the 5-year survival rate in people is approximately 10%. Despite extensive research in diagnostic and therapeutic technologies, very few developments have emerged that significantly improve survival over the last seven decades. Irreversible electroporation (IRE) is a new non-thermal focal tissue ablation technique that uses low-energy electric pulses to destabilize cell membranes, thus achieving tissue death. The procedure is minimally invasive and is performed through small electrodes inserted into the tissue with treatment duration of about one minute. The pulses create an electric field that induces an increase in the resting transmembrane potential (TMP) of the cells in the tissue. The induced increase in the TMP is dependent on the electric pulse parameters. Depending on the magnitude of the induced TMP the electric pulses can have no effect, transiently increase membrane permeability or cause spontaneous death. In this dissertation we hypothesize that irreversible electroporation is capable of ablating normal (gray and white matter) and pathological (MG and/or GBM) brain tissue in a highly focused non-thermal manner that is modulated through pulse parameters and electrode configuration. Through a comprehensive experimental and numerical investigation, we tested and attained results strongly supporting our hypothesis. Specifically, we developed numerical models that were capable of simulating an entire IRE treatment protocol and would take into account pulse parameters (e.g. duration, frequency, repetition rate and strength) in addition to the dynamic changes in tissue electrical conductivity due to electroporation and joule heating, as well as biologically relevant processes such as blood perfusion and metabolic heat. We also provided a method to isolate the IRE effects from undesired thermal damage in models that were validated with real-time temperature measurements during the delivery of the pulses. Finally we outlined a procedure to use 3D volumetric reconstructions of IRE lesions using patient specific MRI scans in conjunction with the models described for establishing field thresholds or performing treatment planning prior to the surgical procedure; thus supplying the readers with the tools and understanding necessary to design appropriate treatment protocols for their specific application. Experimentally we presented the first systematic in vivo study of IRE in normal canine brain and the multimodal treatment of a canine MG patient. We confirmed that the procedure can be applied safely in the brain and was well tolerated clinically. The lesions created with IRE were sub-millimeter in resolution and we achieved 75% tumor volume reduction within 3 days post-IRE in the patient. In addition to the sharp delineation between necrotic and normal brain, the treatments spared the major blood vessels, making it appropriate for treatment of tumors adjacent to, or enveloping critical vascular structures. We believe that irreversible electroporation will play a key role in the treatment of intracranial disorders including malignant brain cancer in which the intent is to focally kill undesired tissue while minimizing damage to surrounding healthy tissue.
Ph. D.
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Neal, II Robert Evans. "Irreversible Electroporation Therapy for the Treatment of Spontaneous Tumors in Cancer Patients." Diss., Virginia Tech, 2011. http://hdl.handle.net/10919/51741.

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Irreversible electroporation is a minimally invasive technique for the non-thermal destruction of cells in a targeted volume of tissue, using brief electric pulses, (~100 µs long) delivered through electrodes placed into or around the targeted region. These electric pulses destabilize the integrity of the cell membrane, resulting in the creation of nanoscale defects that increase a cell’s permeability to exchange with its environment. When the energy of the pulses is high enough, the cell cannot recover from these effects and dies in a non-thermal manner that does not damage neighboring structures, including the extracellular matrix. IRE has been shown to spare the major vasculature, myelin sheaths, and other supporting tissues, permitting its use in proximity to these vital structures. This technique has been proposed to be harnessed as an advantageous non-thermal focal ablation technique for diseased tissues, including tumors. IRE electric pulses may be delivered through small (ø ≈ 1 mm) needle electrodes, making treatments minimally invasive and easy to apply. There is sub-millimeter demarcation between treated and unaffected cells, which may be correlated with the electric field to which the tissue is exposed, enabling numerical predictions to facilitate treatment planning. Immediate changes in the cellular and tissue structure allow real-time monitoring of affected volumes with imaging techniques such as computed tomography, magnetic resonance imaging, electrical impedance tomography, or ultrasound. The ability to kill tumor cells has been shown to be independent of a functioning immune system, though an immune response seems to be promoted by the ablation. Treatments are unaltered by blood flow and the electric pulses may be administered quickly (~ 5 min). Recently, safety and case studies using IRE for tumor therapy in animal and human patients have shown promising results. Apart from these new studies, previous work with IRE has involved studies in healthy tissues and small cutaneous experimental tumors. As a result, there remain significant differences that must be considered when translating this ablation technique towards a successful and reliable therapeutic option for patients. The dissertation work presented here is designed to develop irreversible electroporation into a robust, clinically viable treatment modality for targeted regions of diseased tissue, with an emphasis on tumors. This includes examining and creating proving the efficacy for IRE therapy when presented with the many complexities that present themselves in real-world clinical patient therapies, including heterogeneous environments, large and irregular tumor geometries, and dynamic tissue properties resulting from treatment. The impact of these factors were theoretically tested using preliminary in vitro work and numerical modeling to determine the feasibility of IRE therapy in heterogeneous systems. The feasibility of use was validated in vivo with the successful treatment of human mammary carcinomas orthotopically implanted in the mammary fat pad of mice using a simple, single needle electrode design easily translatable to clinical environments. Following preliminary theoretical and experimental work, this dissertation considers the most effective and accurate treatment planning strategies for developing optimal therapeutic outcomes. It also experimentally characterizes the dynamic changes in tissue properties that result from the effects of IRE therapy using ex vivo porcine renal cortical tissue and incorporates these into a revised treatment planning model. The ability to use the developments from this earlier work is empirically tested in the treatment of a large sarcoma in a canine patient that was surgically unresectable due to its proximity to critical arteries and the sciatic nerve. The tumor was a large and irregular shape, located in a heterogeneous environment. Treatment planning was performed and the therapy carried out, ultimately resulting in the patient being in complete remission for 14 months at the time of composing this work. The work presented in this dissertation finishes by examining potential supplements to enhance IRE therapy, including the presence of an inherent tumor-specific patient immune response and the addition of adjuvant therapeutic modalities.
Ph. D.
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Fastrez, Maxime. "Minimal-invasive management of deep infiltrating endometriosis: diagnosis and treatment." Doctoral thesis, Universite Libre de Bruxelles, 2018. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/271669.

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L’endométriose est une pathologie chronique qui provoque des douleurs pelviennes et une infertilité. On décrit trois phénotypes d’endométriose :l’endométriose péritonéale superficielle, les kystes ovariens d’endométriose (endométriomes) et l’endométriose profonde.L’examen standard pour le diagnostic de l’endométriose est, encore aujourd’hui, la laparoscopie. Nous avons étudié, de façon prospective, l’utilité d’un examen non invasif, la tomographie par émission de positrons (PET), chez les patientes avec suspicion d’endométriose. Nous n’avons pas mis en évidence d’hyperactivité métabolique sur les images de PET pré opératoires, après injection de déoxyglucose marqué au 18F (18FDG), des lésions d’endométriose ayant été confirmées par laparoscopie. Nous avons réalisé, dans un second temps, la même étude après injection d’un analogue de la somatostatine, le DOTATATE, marqué au 68Ga, qui montre une avidité pour les récepteurs à la somatostatine (SSTR) de type 2. Dans cette dernière étude, seules les lésions d’endométriose profonde se sont révélées hyperactives sur les images pré opératoires de PET. Nous avons ensuite réalisé une étude immunohistochimique rétrospective sur différents échantillons d’endométriose superficielle, d’endométriomes et d’endométriose profonde. Nos résultats ont confirmé l’expression de SSTR de type 1 et 5 par les cellules épithéliales des trois phénotypes d’endométriose. Par contre, seules les lésions d’endométriose profonde exprimaient les SSTR de type 2.Le traitement chirurgical des endométriomes et de l’endométriose superficielle est bien codifié. Par contre, la chirurgie de l’endométriose profonde reste au cœur des débats dans la littérature. Nous avons évalué notre aptitude à appliquer les techniques de chirurgie mini-invasive aux procédures complexes telles que la résection des nodules d’endométriose profonde du septum recto-vaginal (NEPSRV). Nous avons évalué la faisabilité de la laparoscopie avec assistance robotique pour une autre procédure complexe :la dissection des ganglions para-aortiques dans le cadre des cancers du col utérin localement avancés. Nous l’avons jugée faisable et sûre pour les patientes. En l’absence de bénéfice démontré de la laparoscopie avec assistance robotique sur la laparoscopie conventionnelle pour le traitement des NEPSRV, nous avons décidé d’évaluer une nouvelle stratégie opératoire mini-invasive de résection des NEPSRV. Nous avons réalisé une analyse des 10 premières patientes opérées selon cette stratégie et avons montré une amélioration significative des symptômes et de la qualité de vie des patientes. Nous avons également étudié la morbidité post opératoire. Nous avons finalement étudié l’apport de la laparoscopie guidée par la fluorescence au traitement des NEPSRV et observé des résultats prometteurs.A l’avenir, les lésions symptomatiques d’endométriose profonde exprimant les SSTR2 pourraient être sélectionnées à l’aide d’un PET au 68Ga-DOTATATE afin d’être traitées, dans le cadre d’essais cliniques, par des analogues de la somatostatine. Ces thérapies ciblées permettaient, dans ces cas, d’éviter la chirurgie. Notre stratégie opératoire mini-invasive pourraient dès lors être appliquée aux lésions n’exprimant pas les SSTR2.
Doctorat en Sciences médicales (Médecine)
info:eu-repo/semantics/nonPublished
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Wu, Ke. "3D segmentation and registration for minimal invasive prostate cancer therapy." Phd thesis, Université Rennes 1, 2014. http://tel.archives-ouvertes.fr/tel-00962028.

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The work of this Thesis is focused on image guided focal therapy of prostate cancer by High Intensity Focused Ultrasound (HIFU). Currently MRI is the only imaging technique that can locate the tumor in prostate. In contrast, the tumor is not visible in the ultrasound image which is used to guide the HIFU planning and therapy. The aim of the Thesis is to provide registration techniques of T2 MRI to ultrasound. Two approaches were explored: 1) Region-based registration. More particularly, we studied an ultrasound texture descriptors based on moments invariant to rotation and scaling. These descriptors are sensitive to speckle distribution regardless of the scale or the orientation. As we expected, some of these descriptors can be used to characterize regions sharing a similar speckle spatial distribution. But, we also found that some other descriptors were sensitive to the contours of these regions. This property seems very useful to adapt the classical boundary-based or mixed region/boundary-based segmentation methods (active contours, graph cut, etc.) to process US images. 2) Surface-based registration approach.. We adapted the Optimal Definition Surface (OSD) method to the segmentation of the prostate in T2 MRI, Furthermore, we proposed the multiple-objects OSD which is a concurrent segmentation of the prostate, bladder and rectum. Finally we used the prostate surface extracted from the ultrasound volume and from T2 MRI in a surface-to-surface elastic registration scheme. This registration allowed us to merge the preoperative MR information in the peroperative US volume.
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Robinson, Richard. "Biomarker and treatment target development in muscle invasive bladder cancer." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/biomarker-and-treatment-target-development-in-muscle-invasive-bladder-cancer(9f7e3dba-9630-4d0d-b7aa-629718d02018).html.

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Introduction: The outcomes following radical treatment for bladder cancer (BC) remain poor, with 5 year overall survival (OS) rates of approximately 50% and over 5000 deaths per year in the U.K. There has been paucity of significant therapeutic developments since the introduction of cisplatinum based chemotherapy in the 1970’s. The aim of this study was to identify putative drug targets for the treatment of this aggressive form of cancer. Methods: A tissue microarray (TMA) was constructed from the cystectomy specimens of 497 BC patients and 70 controls, linked to a clinical database with extended follow up. The online database Oncomine® was interrogated to identify putative treatment targets which were subsequently evaluated using in-vitro models of high grade invasive bladder cancer (using the J82 and T24 cell lines). In-vitro modelling was conducted using siRNA target knockdown during proliferation, chemo-sensitivity, migration and Matrigel™ invasion assays. Expression of the putative targets was then correlated with tumour characteristics and patient outcomes, by IHC and automated image analysis of the TMA. Results: The proteins CYR61 and CTGF were selected from Oncomine® and studied in conjunction with the HGF/MET axis, on the basis of known interactions in other cancer types. siRNA knockdown of both proteins abrogated HGF induced Matrigel™ invasion in both cell lines. CYR61 knockdown significantly reduced HGF induced cell migration and foetal calf serum (FCS) induced Matrigel™ invasion in both cell lines. Knockdown of both proteins also significantly increased the sensitivity of both cell lines to cisplatinum. CYR61 expression was significantly increased in BC samples compared to normal controls and an independent predictor of OS at 6 years (HR 1.493, p=0.030). In contrast, loss of CTGF expression was significantly associated with increasing tumour stage and worse OS. MET expression was reduced in BC compared to controls and not predictive of survival following cystectomy. Conclusions: The in-vitro findings for CTGF as a treatment target were encouraging, although these findings were not supported by the TMA data. CYR61 promotes an aggressive bladder cancer phenotype and knockdown reverses features of EMT and increases chemo-sensitivity. Clinical cohort correlation confirms CYR61 to be a promising treatment target in bladder cancer.
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Skogseth, Haakon R. "Invasive properties of cancer - a treatment target? : In vitro studies in human prostate cancer cell lines." Doctoral thesis, Norwegian University of Science and Technology, Department of Cancer Research and Molecular Medicine, 2007. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-1826.

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Rahn, Helene. "Semi-quantitative röntgentomographische Untersuchungen zur Biodistribution von magnetischen Nanopartikeln in biologischem Gewebe." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-83592.

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Im Rahmen der vorliegenden Dissertationsschrift „Semi-quantitative röntgentomographische Untersuchungen zur Biodistribution von magnetischen Nanopartikeln in biologischem Gewebe“ wurden tomographische Untersuchungen an biologischen Objekten durchgeführt. Bei diesen Objekten handelt es sich um Gewebeproben nach minimal-invasiven Krebstherapien wie zum Beispiel magnetischem Drug Targeting und magnetischer Wärmebehandlung. Der Erfolg dieser Therapien ist sowohl abhängig von der korrekten Verteilung der magnetischen Nanopartikel als auch von der Tatsache, dass diese in der Zielregion in einer ausreichenden Menge vorhanden sind. Das Vorliegen dieser beiden Voraussetzungen ist in der vorliegenden Arbeit untersucht worden. Dabei lag der Schwerpunkt der Arbeit auf der Quantifizierung von magnetischem Material in unterschiedlichen biologischen Gewebeproben mittels Röntgenmikrocomputertomographie (XµCT). Für diesen Zweck wurde ein Kalibrationssystem mit speziellen Phantomen entwickelt, mit dessen Hilfe eine Nanopartikelkonzentration einem Grauwert voxelweise zugewiesen werden kann. Mit Hilfe der Kalibration kann der Nanopartikelgehalt sowohl in monochromatischen als auch in polychromatischen tomographischen Daten im Vergleich zu magnetorelaxometrischen Ergebnissen mit wenigen Prozent Abweichung ermittelt werden. Trotz Polychromasie und damit einhergehenden Artefakten können 3-dimensionale röntgentomographische Datensätze mit einer geringfügigen Konzentrationsabweichung im Vergleich zur quantitativen Messmethode Magnetorelaxometrie semi-quantitativ ausgewertet werden
The success of the minimal invasive cancer therapies, called magnetic drug targeting and magnetic heating treatment, depends strongly on the correct distribution of the magnetic nanoparticles on one side. On the other side it depends on the fact that a sufficient amount of magnetic nanoparticles carrying drugs is accumulated in the target region. To study whether these two requirements are fulfilled motivates this PhD thesis „Semi-quantitative X-ray-tomography examinations of biodistribution of magnetic nanoparticles in biological tissues“. The analysis of the distribution of the magnetic nanoparticles in tumours and other tissue examples is realized by means of X-ray-micro computer tomography (XμCT). The work focuses on the quantification of the magnetic nanoparticles in different biological tissue samples by means of XµCT. A calibration of the tomographic devices with adequate phantoms, developed in the frame of this work, opens now the possibility to analyze tomographic data in a semi-quantitative manner. Thus, the nanoparticle concentration can be allocated voxel-wise to the grey values of the three-dimensional tomographic data. With the help of calibration of the tomography equipments used, polychromatic as well as monochromatic three-dimensional representations of objects can be analyzed with regard to the biodistribution of magnetic nanoparticles as well as with regard to their quantity. The semi-quantitative results have been compared with results obtained with a quantitative measurement method magnetorelaxometry (MRX). Thereby a good agreement of the semi-quantitative and quantitative data has been figured out
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Higgins, Jennifer Ann. "The impact of chemoprevention on treatment regimens for non-muscle invasive bladder cancer." Thesis, University of Leicester, 2011. http://hdl.handle.net/2381/9527.

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Chemoprevention is becoming a highly promising approach to lowering the incidence of cancers. There is, however, insufficient data to determine whether these agents are safe to be used alongside established treatment regimens such as chemotherapy. Non-muscle invasive bladder cancer is readily treatable with surgery (TURBT), yet there is a high rate of recurrence (~60%), 20-30% of patients recurring with the muscle invasive form of the disease, making it a good candidate for chemopreventive intervention. Anthocyanins are one example of dietary compounds currently under investigation as chemopreventive agents. They have been found excreted in the urine of mice at levels capable of causing 50% growth inhibition in cancer cell lines, making them potential bladder cancer chemopreventive agents. Mirtoselect, a standardised bilberry extract containing a mixture of 15 different anthocyanins, was investigated in vitro as a potential chemopreventive agent for bladder cancer alongside chemotherapeutic agent mitomycin C (MMC). Mirtoselect itself was found to inhibit cell survival and growth, causing significant a decrease in clonogenic cell survival, as well as causing an increase in apoptosis in two of the bladder cancer cell lines investigated. In combined studies mirtoselect pre-treatment did not inhibit the effects of MMC in measures of growth, cell survival, apoptosis, cell cycle distribution or DNA damage. In fact, there was a mirtoselect dependent increase in MMC-induced crosslinks, an enhancement of MMCs anti-proliferative effects at low concentrations of mirtoselect and in some instances apoptosis was greater than additive. Furthermore mirtoselect was shown to enhance the DNA damaging effects of radiation. Mirtoselect itself appears to be a good chemopreventive candidate for non-muscle invasive bladder cancer. In combination it does not appear to interfere with the cytotoxic actions of MMC, potentially enhancing its effects, and could also provide a therapeutic advantage in radiotherapy, therefore warranting further investigation for use in clinic.
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Colquhoun, Alexandra J. "The use of radiosensitising agents in the treatment of muscle-invasive bladder cancer." Thesis, University of Leicester, 2005. http://hdl.handle.net/2381/35621.

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Radical radiotherapy is the principal bladder-preserving treatment for muscle-invasive bladder cancer. 70% of muscle-invasive bladder cancers express epidermal growth factor receptor (EGFR), which is associated with poor prognosis. Recent evidence suggests that ionising radiation (IR) stimulates EGFR causing activation of cytoprotective signalling cascades, thereby mediating radioresistance. Tumour tissue from 110 patients who received radical radiotherapy for muscle-invasive bladder cancer was immunohistochemically stained for EGFR. Multivariate analysis assessed the prognostic utility of tumour EGFR status in predicting outcome following radical radiotherapy. The effect of IR on EGFR activation, and also on signalling pathways downstream of EGFR was assessed using Western blotting. Potential inhibition of radiation-induced activation of EGFR was assessed using the two small molecule tyrosine kinase inhibitors (TKI) Iressa and Tarceva. Finally we assessed the activity of TKI as a single agent treatment and in combination with IR, in vitro and in vivo. 72% of tumours stained positively for EGFR and 69% of these exhibited positive response to radiotherapy. Positive response to radiotherapy correlated significantly with negative EGFR status (X2 test; p=0.05). Response to radiotherapy at 3-months, local recurrence, metastatic spread and presence of ureteric obstruction were independent prognostic factors for diminished bladder cancer-specific survival. IR activated EGFR and Iressa partially inhibited this activation. Radiation-induced activation of EGFR activated MAPK and Akt but not STATl. Activation of the MAPK but not Akt was partially inhibited by Iressa. Bladder cancer cells treated with combined TKI and IR exhibited significantly greater growth inhibition in comparison to treatment with either IR or TKI alone both in vitro and in vivo (p=0.001-0.04). IR activates EGFR in bladder cancer cells and this activation is partially inhibited by TKI. Treatment of bladder cancer cells using combined TKI and IR results in significantly greater growth inhibition both in vitro and in vivo. Given the high frequency of EGFR expression by bladder tumours and its importance in local tumour control there is now justification to translate this work into a clinical trial.
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Books on the topic "Minimal invasive cancer treatment"

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Central Council for Research in Ayurveda and Siddha (India). Select research papers on Ksharasutra (a minimal invasive ayurvedic para-surgical measure). New Delhi: Central Council for Research in Ayurveda and Siddha, Department of AYUSH, Ministry of Health and Family Welfare, Government of India, 2009.

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Thüroff, Stefan, and Christian G. Chaussy. Focal Therapy of Prostate Cancer: An Emerging Strategy for Minimally Invasive, Staged Treatment. Springer, 2015.

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Thüroff, Stefan, and Christian G. Chaussy. Focal Therapy of Prostate Cancer: An Emerging Strategy for Minimally Invasive, Staged Treatment. Springer, 2016.

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Ahmed, Hashim Uddin, Louise Dickinson, and Mark Emberton. Focal therapy for prostate cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0065.

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Minimally-invasive therapies in localized prostate cancer offer the potential to reduce side effects and the healthcare burden/costs associated with radical modalities such as surgery or radiotherapy. As radical treatments carry significant perioperative morbidity (wound infection, haemorrhage, hospital stay), potentially life-long side effects (such as incontinence, erectile dysfunction, rectal toxicity), and fail to cure many men, ablative therapies that reduce treatment burden while retaining acceptable cancer control have increasingly become areas of evaluation. This chapter reviews the role of these approaches and the therapeutic dilemma that men with localized low volume prostate cancer currently face as in the context of novel therapies which aim to find a middle ground—tissue-preserving focal therapy—that follows the paradigm of almost all other solid organ cancers.
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Brown, Jim, and Neal Navani. Non-surgical management of early-stage lung cancer. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0004.

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As low-dose computed tomography screening of ‘high-risk’ smokers is occurring with increasing frequency, the incidental discovery of solitary pulmonary nodules is becoming more frequent, and lung cancer multidisciplinary teams are now often faced with balancing risk and benefit when making decisions regarding the radical treatment of patients with a clinical diagnosis of early lung cancer but borderline fitness. Surgery offers the best prospect of cure but is associated with significant mortality and morbidity; the elderly and frail experience more toxicity and a greater impact on the quality of life. This chapter reviews the criteria for assessing surgical fitness and examines the evidence for minimally invasive and ablative techniques for the treatment of early peripheral lung cancer in the medically inoperable patient.
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Pagano, Francesco, and Pierfrancesco Bassi. Invasive Bladder Cancer. Springer, 2016.

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(Editor), PierFrancesco Bassi, and Francesco Pagano (Editor), eds. Invasive Bladder Cancer. Springer, 2007.

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(Editor), James G. Geraghty, Howard L. Young (Editor), Jonathan M. Sackier (Editor), H. Stephen Stoldt (Editor), and Riccardo A. Audisio (Editor), eds. Minimal Access Surgery in Oncology. Greenwich Medical Media, 1998.

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Zehnder, Pascal, and George N. Thalmann. Muscle-invasive bladder cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0078.

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In the United Kingdom, >4,000 people die of bladder cancer every year. This reflects around one-third of affected patients and occurs in those with primary metastatic disease, with invasion at presentation, and in persons whose tumour progresses to invasion from non-invasive disease. The outcome from invasive cancers has not dramatically altered over the last 30 years, due to a lack of screening programmes, a lack of advances in treatment, and the fact that many patients present with tumours at an advanced stage. Around 50% of patients with invasive disease die from bladder cancer despite radical treatment, suggesting the disease is metastatic at presentation. Cure is rarely possible in patients with locally advanced tumours and lymph node metastases. Therapeutic options include systemic chemotherapy and salvage radical treatment for responders or palliation. Following radical cystectomy for cancer, patients require lifelong follow-up for both oncologic and functional reasons.
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Mario, Dicato, Mathé Georges, and Reizenstein Peter 1928-, eds. Management of minimal residual malignancy in man. Oxford: Pergamon, 1988.

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Book chapters on the topic "Minimal invasive cancer treatment"

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Ma, Cheng-Jen, and Jaw-Yuan Wang. "Safe Bowel Anastomosis in Minimal Invasive Surgery for Colorectal Cancer." In Surgical Treatment of Colorectal Cancer, 309–14. Singapore: Springer Singapore, 2018. http://dx.doi.org/10.1007/978-981-10-5143-2_28.

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Milsom, Jeffrey W., Pierenrico Marchesa, and Andrea Vignali. "Minimally invasive surgery in surgical oncology." In Cancer Treatment and Research, 309–29. Boston, MA: Springer US, 1997. http://dx.doi.org/10.1007/978-1-4615-6165-1_16.

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White, Michael, Yuman Fong, and Laleh Melstrom. "Minimally Invasive Surgery of the Liver." In Cancer Treatment and Research, 221–31. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-34244-3_11.

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Pradhan, Rashmi P., and Jill R. Dietz. "Endoscopic Diagnosis and Treatment of Breast Diseases." In Minimally Invasive Cancer Management, 331–41. New York, NY: Springer New York, 2009. http://dx.doi.org/10.1007/978-1-4419-1238-1_24.

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Holder, Walter D., and Richard L. White. "Sentinel Lymph Node Biopsy in the Treatment of Cancer." In Minimally Invasive Cancer Management, 348–65. New York, NY: Springer New York, 2001. http://dx.doi.org/10.1007/978-1-4757-3444-7_27.

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Claassen, Yvette H. M., Henk H. Hartgrink, Wobbe O. De Steur, Marije Slingerland, and Cornelis J. H. Van de Velde. "Neoadjuvant Treatment of Gastric Cancer." In Minimally Invasive Surgery for Upper Abdominal Cancer, 149–57. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-54301-7_14.

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Moreno-Sanz, Carlos, and Miguel A. Cuesta. "Minimally Invasive Treatment of Gastric GIST." In Minimally Invasive Surgery for Upper Abdominal Cancer, 189–93. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-54301-7_18.

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Holzer, E. "Minimal Invasive Cancer of the Cervix: Morphologic Definitions and Clinical Consequences." In Colposcopy in Diagnosis and Treatment of Preneoplastic Lesions, 84–88. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-72761-0_21.

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Janzen, Nicolette K., Kent T. Perry, and Peter G. Schulam. "Laparoscopic Radical Nephrectomy and Minimally Invasive Surgery for Kidney Cancer." In Cancer Treatment and Research, 99–117. Boston, MA: Springer US, 2003. http://dx.doi.org/10.1007/978-1-4615-0451-1_6.

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Pouw, Roos E., and Bas L. A. M. Weusten. "Endoscopic Treatment of Early Esophageal Cancer." In Minimally Invasive Surgery for Upper Abdominal Cancer, 21–31. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-54301-7_3.

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Conference papers on the topic "Minimal invasive cancer treatment"

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Luyen, Hung, Fuqiang Gao, Susan C. Hagness, and Nader Behdad. "High frequency microwave ablation for targeted minimally invasive cancer treatment." In 2014 8th European Conference on Antennas and Propagation (EuCAP). IEEE, 2014. http://dx.doi.org/10.1109/eucap.2014.6902062.

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Sarkar, Saugata, and Marissa Nichole Rylander. "Treatment Planning Model for Nanotube-Mediated Laser Cancer Therapy." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-192997.

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The goal of the project is to develop an effective treatment planning computational tool for nanotube-mediated laser therapy that maximizes tumor destruction and minimizes tumor recurrence. Laser therapies can provide a minimally invasive treatment alternative to surgical resection of tumors. However, the effectiveness of these therapies is limited due to nonspecific heating of target tissue and diffusion limited thermal deposition which often leads to healthy tissue injury and extended treatment durations. These therapies can be further compromised due to induction of molecular chaperones called heat shock protein (HSP) in tumor regions where non-lethal temperature elevation occurs causing enhanced tumor cell viability and imparting resistance to chemotherapy and radiation treatments which are generally employed in conjunction with hyperthermia.
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Etheridge, Michael L., and John C. Bischof. "Investigating Electromagnetic Field, Nanoparticle Design, and Treatment Volume for Magnetic Nanoparticle Thermal Therapy." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80779.

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Magnetic nanoparticle (MNP) based thermal therapies are currently approved in Europe and poised for clinical translation in the US. The main benefits include the ability to focally and repeatedly treat tissues, including cancers, with a minimally-invasive platform. Nevertheless, a more complete understanding and control of MNP heating is necessary to effectively translate the approach to treat different sizes and geometries of cancer (See Figure 1). The present work discusses contrasts in heating between superparamagnetic and ferromagnetic nanoparticles (sMNP and fMNP), electromagnetic field-dependant MNP response, scaling of MNP volumetric heating, and the ability of theory to predict this behavior.
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Szot, Christopher S., Christopher B. Arena, Paulo A. Garcia, Rafael V. Davalos, Joseph W. Freeman, and Marissa Nichole Rylander. "A Novel In Vitro Model for Irreversible Electroporation Based Cancer Therapies and Treatment Planning." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53929.

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Irreversible electroporation (IRE) is a minimally invasive, localized, non-thermal tissue ablation technique that has shown tremendous promise as an effective cancer therapy option. This procedure uses electrodes to apply a series of short-duration, high intensity electric pulses to a targeted tissue region. These pulses can produce irreversible structural changes in the cell membranes within the targeted region, generating a controllable range of cell death [1].
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Tranoulis, A., D. Georgiou, G. Mehra, S. Rajkumar, C. Founta, A. Sayasneh, and R. Nath. "EP1292 Minimally invasive palliative treatment of vulval cancer: is there a role for electrochemotherapy?" In ESGO Annual Meeting Abstracts. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/ijgc-2019-esgo.1297.

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Gennari, P., A. Ignatov, M. Gerken, and O. Ortmann. "Minimally invasive vs open hysterectomy for the treatment of early cervical cancer retrospective population-based cancer registry study." In Kongressabstracts zur Tagung 2020 der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG). © 2020. Thieme. All rights reserved., 2020. http://dx.doi.org/10.1055/s-0040-1718136.

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Elkhalil, H., J. C. Bischof, and V. H. Barocas. "Cryoinjury of a Contractile Tissue-Equivalent: In Vitro Experiments." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-192819.

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Cryosurgery, the minimally-invasive destruction of undesirable tissues by freezing, is an attractive technique for treating diseases where tight control over lesion size and minimal scar tissues are crucial, such as cancer and dermatologic disorders (1, 2). Unlike hyperthermic (high temperature) treatments, cryosurgery maintains the integrity of the extracellular matrix (ECM) while destroying the cells of the tissue. The undamaged ECM results in a unique wound healing process, which, compared to most injuries, leads to a better tissue recovery. Thus, cryosurgery has been of great interest in many clinical fields and has been studied extensively. However, numerous questions remain.
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Neal, Robert E., Ravi Singh, Suzy Torti, and Rafael V. Davalos. "Feasibility Study for Applying Irreversible Electroporation to the Treatment of Breast Cancer." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206732.

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Non-thermal irreversible electroporation (IRE) is a new, minimally invasive, localized tissue ablation technique [1]. The procedure uses electrodes to deliver short-length, high voltage electric pulses to destabilize a cell membrane, leading to the creation of nanopores. When the pulses are strong enough, the cell cannot repair the damage and dies [2]. It has been shown that substantial volumes of tissue and cutaneous tumors may be ablated in a non-thermal manner using irreversible electroporation [1, 3]. In addition, this procedure may be predicted by numerical modeling, promotes an immune response, leaves the extracellular matrix intact, does not affect nerves, may be monitored in real-time, and preserves tissue vasculature [2–5].
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Whitney, Jon, Harry Dorn, Chris Rylander, Tom Campbell, David Geohegan, and Marissa Nichole Rylander. "Spatiotemporal Temperature and Cell Viability Measurement Following Laser Therapy in Combination With Carbon Nanohorns." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19619.

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Cancer remains one of the most deadly diseases today. Laser-induced photothermal therapy can provide a minimally invasive treatment alternative to surgical resection. The selectivity and effectiveness of laser therapy can be greatly enhanced when photoabsorbing nanoparticles such as nanoshells, single walled carbon nanotubes, multi-walled carbon nanotubes, or single wall carbon nanohorns (SWNHs) are introduced into the tissue. Prior studies have effectively used SWNHs combined with near infrared (NIR) laser light to target and destroy microbes [1]. We have previously reported increased tumor cell destruction when SWNHs were used in combination with laser therapy. The present work provides more extensive characterization of cell viability in response to laser therapy alone or in combination with SWNHs. Furthermore, the spatiotemporal temperature and cell viability in vitro in response to combinatorial SWNH-mediated laser therapies is determined using infrared thermometry and a novel viability algorithm, respectively. These new measurements will be critical for planning SWNH-mediated laser treatments where knowledge of the geometric distribution of temperature and cell death are critical to achieving the goal of selectively eliminating a tumor with specific spatial margins with minimal damage to surrounding healthy tissue.
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Cuevas, Carlos, Ashley M. Dotson, and Sunil R. Hingorani. "Abstract B74: Minimally invasive ablative therapy for mucinous cystic neoplasms (MCN) in a genetically engineered mouse model." In Abstracts: AACR Special Conference on Pancreatic Cancer: Innovations in Research and Treatment; May 18-21, 2014; New Orleans, LA. American Association for Cancer Research, 2015. http://dx.doi.org/10.1158/1538-7445.panca2014-b74.

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Reports on the topic "Minimal invasive cancer treatment"

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Shtern, Faina. Image-Guided, Minimally Invasive Diagnosis and Treatment of Prostate Cancer. Fort Belvoir, VA: Defense Technical Information Center, December 2005. http://dx.doi.org/10.21236/ada450602.

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Fei, Baowei, David L. Wilson, Jeffrey L. Duerk, and D. B. Sodee. Molecular Imaging for IMRI-Guided Minimally Invasive Treatment of Prostate Cancer. Fort Belvoir, VA: Defense Technical Information Center, March 2004. http://dx.doi.org/10.21236/ada425929.

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