Abstract:
In the treatment of a tumor with radiation therapy is enhanced by a weak magnetic field, the field strength time sequence of exposure and shape and contour of the magnetic field are varied to achieve desired results. In one separate aspect, exposure to a magnetic field is continued after exposure to a free radical-creating therapy is ceased or diminished, thereby increasing the lifetimes of free radicals which have already been created. In another preferred embodiment a magnetic field is strategically placed to avoid extending the lives of free radicals in tissue through which a free radical-creating beam must pass, to reach a tumor. This application discloses quantitative parameters for field strength and exposure time to create concentrations and reactivity of free radicals, including long-lived free radicals and discloses the use of shaped, contoured, and designed electromagnetic fields. A treatment planning station is also disclosed.

Description:
RELATED APPLICATIONS 
     This application is a continuation-in-part of application Ser. No. 14/356,747, filed May 7, 2014 which is in turn a continuation of international application serial number PCT/US13/66820, filed on Oct. 25, 2013, which is incorporated herein by reference as if fully set forth herein, and which, in turn, claims priority from provisional application Ser. No. 61/718,896, filed Oct. 26, 2012, which is also incorporated by reference as if fully set forth herein. 
    
    
     BACKGROUND 
     The present invention relates to methods and devices for treating malignant tumors. More specifically the present invention relates to methods and devices for killing tumor cells by creating free radicals in a tumor, and extending the lifetime and modifying the reaction kinetics of the free radicals by exposing them to a magnetic field. 
     A central problem in cancer treatment is that of preserving healthy tissue while destroying cancerous tissue. Although radiation therapy generally involves the focusing of radiation on a tumor, at least some healthy tissue generally is located in the irradiated field. This healthy tissue is exposed to and to some degree damaged by the radiation. In chemotherapy healthy tissue is exposed to the chemotherapy agent and may be damaged. 
     Moreover, research has shown that much of the effect of radiation therapy and a substantial component of some approaches to chemotherapy are mediated by free radical effects in tumor tissue. The mechanisms whereby free radicals produce tumor cell death include direct enzymatic effects, DNA damage and induction of apoptotic pathways. 
     Our understanding of the physics and chemistry of free radicals and paired radicals has gradually increased over the past ten years. A free radical is any chemical species capable of an independent existence that has an unpaired electron in its valence shell. The presence of an unpaired electron in the valence shell causes free radicals to be paramagnetic and exhibit magnetic properties when exposed to a magnetic field. 
     Free radicals may be formed by any of several mechanisms including but not limited to: Ultraviolet induced homolytic fission as may be encountered in laser ablation therapy of tumors; Specific chemical reactions as encountered with pharmacological chemotherapy e.g. bleomycin; Ionizing radiation as the result of external beam irradiation, antibody directed or site selective radio-nucleotide administration or through implantation radiotherapy e.g. prostatic brachyotherapy; Thermal induction as in hyperthermic therapy; or Ultrasound induced acoustic cavitation. 
     Free radicals once generated may recombine. The biologic effects of free radicals in tissue are determined by the net reactive fraction namely the “escape” population that does not recombine rapidly. Factors, which influence pair recombination, include the viscosity of the reaction environment, temperature, bystander effects and the quantum state of the free radical. The quantum state of the free radical is defined by the applicable Schrodinger equation (H.PSI.=E.PSI.) where H is a Hamiltonian operator and .PSI. are sets of wave functions (Eigenfunctions). The Eigenfunctions are defined by a set of four quantum numbers: n—the principal quantum number, 1—the orbital quantum number, M.sub.1—the magnetic quantum number and M.sub.s—the spin quantum number. Of particular significance to this discussion is the spin quantum number. 
     The spin quantum number for an unpaired orbital electron can assume one of two values either +½ or −½. The wave distribution function determined by spin quantization is a vector quantity and subject to influence by a superimposed magnetic field. When two electrons share an orbital space they must have opposite spin polarity. This phenomenon is dictated by the Pauli Exclusion Principal that postulates that no two electrons can occupy the same quantum state. 
     Spin polarity is conventionally referred to as up spin (.uparw.)+½ or down spin (.dwnarw.)−½. Shared valence electrons in the formation of chemical bonds also must have opposite spin polarity. When covalent bonds are severed as in the formation of free radicals spin polarity is preserved. 
     The unpaired electron in the valence orbital of a free radical in a magnetic field will precess in a manner comparable to Larmor precession described for charged particles in classic electrodynamics. Quantum precession leads to spin phase transitions between the singlet state where antiparallel spin vectors apply and triplet states where parallel spin vectors apply. The singlet state is favorable for recombination because antiparallel spin orientation is preserved and a covalent bond can be established. Triplet state configurations are unfavorable for recombination because parallel spin orientation is induced. In a magnetic field there are three triplet state configurations, which are vector quantities that due to precession in the magnetic field are no longer energy equivalent and are said to be nondegenerate. 
     The strength of the applied magnetic field, which maximizes the spin phase mixing effect, is dependent on the quantum state of the free radical or the system of free radicals. In general optimum phase mixing is achieved at relatively low magnetic field strengths (0.1-10.0 mTesla) within the hyperfine coupling energy levels of the radical pair. 
     The singlet state (S.sub.1) characterized by antiparallel spin vectors will prevail in the absence of a magnetic field when homolytic fission of a covalent bond occurs to form a free radical pair. In the presence of a magnetic field of appropriate strength, the triplet states, T.sub.−1, T.sub.0 and T.sub.−1 are equally probable energy states and are distinct and nondegenerate. The theoretic distribution between singlet and triplet states will be 25% singlet and 75% triplet. Such a distribution will theoretically increase the effective concentration of escape radicals by 75%. In experimental situations the yield is limited by non-quantum factors including viscosity effects, temperature, diffusion and bystander effects. However, increases in escape radical reactivity of 20-40% are documented in experimental systems where free radical escape reactions are measured. 
     U.S. Pat. Nos. 6,679,827 and 6,926,659 disclose a method for enhancing irradiation tumor treatment by creating a magnetic field that intersects with the irradiating beam in the area of the tumor. Referring to  FIG. 1 , showing a technique disclosed in these patents, a patient&#39;s body  10  is subjected to radiation  12  that travels through the body  10  in a first direction. A magnet  18  is oriented so as to create a magnetic field  20  in the vicinity of a tumor  22  of one milli-Tesla (mT). In another technique disclosed, shown in  FIG. 2 , a tumor  22  may be treated by placing radioactive strips  30  about it. Additionally, magnetic strips  32  are placed to create a magnetic field in the tumor  22 . Referring to  FIG. 3 , in another prior art technique, a laparoscope  40  is used to introduce a magnet  42  directly into the tumor. Finally, referring to  FIG. 4 , a tumor may be treated by a set of radioactive beads  50  and a set of magnetic beads  52 , adapted to create a magnetic field. The treatment described is time static in the sense that the irradiating beam and the magnetic field are disclosed as being simultaneous. 
     Much of the clinical efficacy of radiation therapy tumor treatment stems from actions by ionization-induced free radical production and changes in their combinatorial kinetics. Although it has been shown that weak magnetic fields influence free radical behavior in irradiated tissue, this knowledge has not been fully exploited in the treatment of tumors. 
     SUMMARY 
     In the treatment of a tumor with radiation therapy enhanced by a weak magnetic field, the field strength time sequence of exposure and the shape and contour of the magnetic field are varied to achieve desired results. In one separate aspect, exposure to a magnetic field is continued after exposure to a free radical-creating therapy is ceased or diminished, thereby increasing the lifetimes of free radicals that have already been created. In another preferred embodiment a magnetic field is strategically placed to avoid extending the lives of free radicals in tissue through which a free radical-creating beam must pass, to reach a tumor. This application discloses quantitative parameters for field strength and exposure time to create concentrations and reactivity of free radicals, including long-lived free radicals and discloses the use of shaped, contoured, and designed electromagnetic fields. A treatment modeling station is also disclosed. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
         FIG. 1  is an illustration of a tumor being treated by radiation therapy augmented by a magnetic field. 
         FIG. 2  is an illustration of a tumor being treated by strips of implanted radioactive material interspersed with strips of implanted magnetic material. 
         FIG. 3  is an illustration of a tumor into which a magnet has been introduced by a laparoscope. 
         FIG. 4  is an illustration of a tumor that is being treated by a combination of radioactive beads and magnetic beads. 
         FIG. 5  is an illustration of a tumor that is being treated by a combination of irradiation and a magnetic field created by two electromagnets. 
         FIG. 6  is an illustration of a tumor that is being treated by a combination of irradiation and a magnetic field created by two permanent magnets. 
         FIG. 7  is a flow chart of a method of treating a tumor. 
         FIG. 8  shows a user station adapted to facilitate the development of a treatment plan. 
         FIG. 9  is a graph showing the effects of tumor radiation and electromagnetic field strength on tumor cell death. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     In a preferred set of embodiments, free radicals created to kill tumor cells have their lifetimes extended by a weak magnetic field (in the range of 10 to 100 gauss), shaped and timed to extend free radical lifetimes in the tumor, while avoiding to the extent possible, extending free radical lifetimes in surrounding tissue. 
     In one preferred embodiment tumor cells are exposed to levels of 2 to 6 Gy of Co-60 gamma radiation (IR) stimulus, with simultaneous exposure to DC field strengths ranging from 10 to 100 gauss (1 to 10 millitesla), with the DC electromagnetic field exposure continuing for up to one hour after cessation of the IR. In other preferred embodiments other forms of stimulus for producing free radicals are used, including chemotherapy, other forms of radiation and exposure to induced ultrasound, ultraviolet, thermal, or sonic cavitation energy. Magnetic field persistence after cessation of stimulus is between 1 minute and 10 hours. 
     Referring to  FIG. 5 , in one preferred embodiment, a machine  110  is used to provide the tumor treating radiation and magnetic field. A control computer  112 , controls an electromagnetic current source  114 , which controls the electromagnets  116 , including turning them off and/or rapidly sequencing a planned variable strength field. The computer  112  also controls the radiation beam level control  118 , which controls the intensity of the radiation beam  122 , from the radiation beam source  120 . Radiation beam  122  travels through a human body  124  and reaches and travels through a tumor  126 . An electromagnetic field, having axis  130  helps to perpetuate free radicals produced by the radiation beam  122 .  FIG. 6  shows a machine that is the same as that of  FIG. 5 , except for that permanent magnets  130  are used, in order to produce a very thin magnetic field, to restrict the magnetic field effects as much as possible to the tumor. Because it is beneficial for magnets  130  to be very accurately aligned, in one embodiment they are not moved, but the patient is moved upwardly by a bed lift mechanism  132 , so that magnets  130  can be laser aligned prior to a patient being treated, without having to be moved into position after alignment, which could cause some of the precision of the alignment to be lost during this movement. A magnetic field interrupting mechanism  134  (in one embodiment mounted on a rotating shaft) can be used to block the magnetic field, in one embodiment in a periodic manner coordinated with the radiation beam source  120  and contoured to conform to tumor shape. 
     Referring to  FIG. 7 , showing a preparation and treatment scheme  150  begins with a determination, based on tumor location, of the positioning of magnets  116  ( FIG. 5 ) and radiation beam source  120  (block  152 ). Then, given these locations, the maximum permissible radiation exposure for the interposed tissue is computed (block  154 ). Next, given these limits, the maximum effectiveness scheme of exposure to a radiation beam and a magnetic field is determined (block  156 ). As it is impossible to expose only the tumor to the magnetic field, the effect of the magnetic field on the radiation beam effect on interposed tissue must be taken into consideration in this determination. After this, the magnets and radiation sources are physically positioned relative to the body (block  158 ) and treatment is undertaken, according to the scheme (block  160 ). 
     The increase in the efficacy of the treatment, for the case of a radiation is given by:
 
ΔEffectiveness=Int TT (ΔEBS)−(Int IT+PTT (ΔEBS))
         Where Int is the integral over the volume indicated in the superscript and   TT=Tumor Tissue; and IT+PTT=Interposed Tissue and Post Tumor Tissue;   And EBS=Effective Beam Strength       

     The amount of time that the tumor tissue can be irradiated will be limited by the effective strength of the beam as it crosses the tissue that is interposed between the body exterior surface and the effective strength of the beam as it passes through the tissue interposed between the tumor (on the backside relative to the beam source) and the body exterior surface. Accordingly, in a preferred embodiment, the difference between the increase in beam strength between the tumor tissue and the interposed tissue and post tumor tissue is maximized. In one method of doing this a pair of permanent magnets that have been laser aligned are provided and the patient is moved into position between them. With this method the magnets do not have to be moved to be positioned correctly relative to the patient. Such movement could reduce the alignment of the magnets. Also, the magnetic field between the two magnets can be measured while no patient is interposed, to verify alignment and magnetic field strength. Although the presence of a human body will change the field characteristics, it is still helpful to know the magnetic field when no body is interposed. In one preferred embodiment, after the patient is moved into position, while maintaining alignment by the use of a track or guide, the magnets are moved so that they approach or touch the patient&#39;s skin on either side. The magnets may be placed slightly toward the anterior of the tumor, referenced to the beam source. In a preferred embodiment, the magnetic field at its maximum point within the tumor, is at the low end of the effective range, so that the magnetic field in the non-tumor areas is below the effective range. Although the magnetic field in these areas may still have some positive effect on the effective beam strength, it is not as great as the effect within the tumor. 
     In a preferred embodiment, a first radiation beam strength is applied for long enough to raise the concentration of free radicals to a desired level. Then a second radiation beam strength may be applied to maintain the free radical concentration and reactivity at near optimal levels. Sequential fractionation may be employed to maximize the compounding benefits of sequential magnetic field exposures or variable radiation beam strength exposure or exposures designed to optimize for a given free radical composition. That is, the magnetic field strength and/or the radiation beam strength may be varied over time. 
     In one preferred embodiment the radiation beam producing device produces a rapidly sequenced magnetic field that, in the tumor, coincides with the exposure to a radiation field of planned strength, variation over time and contour and conforms to a preplanned and contoured electromagnetic field. In one method, the magnetic field continues after the pulse has passed through the tumor, but turns off for a brief period of time, as the beam is passing through interposed tissue. If electromagnets are used, the magnetic field is varied by varying the strength of the electric current through the electromagnets. In the case of permanent magnets (or electromagnets) a rotating shielding can be periodically interposed between the magnets, thereby disrupting the magnetic field. 
     In an alternative preferred embodiment there is no time coincidence between exposure to radiation and application of a magnetic field. Rather, the patient is first exposed to radiation, and then exposed to a magnetic field. One advantage of this technique is that the room used for radiation does not have to be modified to include magnets. Further the patient can be removed from the room in which the exposure to radiation takes place, to another room where the application of the magnetic field can occur. This frees the radiation room for greater patient throughput. 
     Referring to  FIG. 8 , in a preferred embodiment a treatment modeling station  200 , having a display screen  202 ; a standard keyboard and mouse set of input devices  206 ; and a processor and memory assembly  204 , is provided to aid a health care provider in planning treatment. In one embodiment, this device is a standard computer, such as a standard WINDOWS® OS, LINUX® OS or APPLE® computer, running specialty software. X-ray or ultrasound imagery, in the instance shown, showing a patient&#39;s abdomen  212  and a tumor  214  in the abdomen  212 , may be loaded onto the device memory  204  and displayed, as shown. The health care provider is able to move symbolic shapes indicating magnet  216  and radiation source  218  positions, and increase or decrease magnet and radiation source intensity. A false color map  220  shows the effective beam strength, and a reading of total tumor effective radiation and healthy tissue effective radiation is provided  222 , for a given time progression of treatment events, which may be entered and modeled. The time progression can be displayed at either real time or faster than real time, to indicate the effects of treatment. After the radiation source is turned off, a beam may still be shown indicating the continuing effects of free radicals that continue to exist. A time gap between the cessation of radiation exposure and the beginning of exposure to a low strength magnetic field, may be set by a user through use of the user controls. In one embodiment station  200  is enabled to recommend a treatment sequence. 
       FIG. 9  is a bar graph that shows the effectiveness of 4Gy of gamma radiation in the case where it is not accompanied by a magnetic field, when accompanied by a 15 gauss electromagnetic field (middle column) and when accompanied by a 15 gauss magnetic field that is continued for 15 minutes after the gamma radiation is discontinued. 
     The present invention finds industrial applicability in the manufacturing of machinery for treating a tumor. 
     While a number of exemplary aspects and embodiments have been discussed above, those possessed of skill in the art will recognize certain modifications, permutations, additions and sub-combinations thereof. It is therefore intended that the following appended claims and claims hereafter introduced are interpreted to include all such modifications, permutations, additions and sub-combinations as are within their true spirit and scope.