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水过滤红外辐射全身热疗:技术物理方面及临床经验

Whole-body hyperthermia with water-filtered infrared radiation: technical-physical aspects and clinical experiences.

作者信息

Wehner H, von Ardenne A, Kaltofen S

机构信息

Von Ardenne Clinic for Systemic Cancer Multistep Therapy, Dresden, Germany.

出版信息

Int J Hyperthermia. 2001 Jan-Feb;17(1):19-30. doi: 10.1080/02656730150201561.

Abstract

Among the different methods of whole-body hyperthermia (WBH), the energy transfer with infrared radiation seems to have established itself as a relatively simple procedure. The infrared systems differ with regard to the used spectrum of radiation. In the case of water-filtered infrared radiation, infrared A (760-1400 nm) is the focal point of heat radiation. This radiation penetrates deep into the skin up to the capillary area of the corium. Eighty treatments of patients in an advanced stage of cancer (40 male, 40 female, April 1998-April 1999) were performed with a WBH device with water-filtered infrared radiation, IRATHERM 2000. Extreme WBH was combined with induced hyperglycaemia and relative hyperoxaemia, and for 83% of the patients with chemotherapy as well. The body-core temperature was measured rectally (85%) or vesically. The objectives of the thermal control were a low rate of side-effects and a quick rise of the body-core temperature with regard to the condition of the patient's skin. The mean duration of the rising phase (37.5-41.5 degrees C) was 87 +/- 19 min. A correlation between lamp power and rising time (r = 0.08) was not found. Moreover, no correlation could be found between the appearance of thermal lesions > or = WHO 2nd degree and the lamp power. Thermal lesions according to WHO 1st, 2nd and 3rd degrees appeared in the case of 20, 15 and one treatment, respectively. Their area amounted in 2nd-degree cases to 0.08% of the body surface, on average. The highest mean temperature over 60 min (T60) was 42.1 +/- 0.1 degrees C, and the mean of maximum temperature (Tmax) was 42.3 +/- 0.1 degrees C. The mean thermal isoeffect dose EM43 was 35.8 +/- 6.3 min. WBH with water-filtered infrared radiation in combination with induced hyperglycaemia and relative hyperoxaemia (procedure of systemic Cancer Multistep Therapy) is a safe and practicable procedure with good tolerability in the case of experienced application. It permits a rapid rise of body-core temperature and a high thermal constancy in the plateau phase. An all-around access to the patient is possible in all therapy phases.

摘要

在全身热疗(WBH)的不同方法中,利用红外辐射进行能量传递似乎已成为一种相对简单的操作程序。红外系统在所用辐射光谱方面存在差异。就水滤过红外辐射而言,红外A(760 - 1400纳米)是热辐射的焦点。这种辐射可深入皮肤至真皮的毛细血管区域。1998年4月至1999年4月期间,使用配备水滤过红外辐射的WBH设备IRATHERM 2000对80例癌症晚期患者(40例男性,40例女性)进行了治疗。极热全身热疗联合诱导性高血糖和相对性高氧血症,并且83%的患者还联合了化疗。通过直肠(85%)或膀胱测量体核温度。热控目标是副作用发生率低以及根据患者皮肤状况使体核温度快速上升。体温上升阶段(37.5 - 41.5摄氏度)的平均持续时间为87 ± 19分钟。未发现灯功率与升温时间之间存在相关性(r = 0.08)。此外,在出现≥WHO 2级热损伤与灯功率之间也未发现相关性。分别在20次、15次和1次治疗中出现了WHO 1级、2级和3级热损伤。在2级病例中,其面积平均占体表的0.08%。60分钟内的最高平均温度(T60)为42.1 ± 0.1摄氏度,最高温度平均值(Tmax)为42.3 ± 0.1摄氏度。平均热等效剂量EM43为35.8 ± 6.3分钟。水滤过红外辐射全身热疗联合诱导性高血糖和相对性高氧血症(系统性癌症多步骤治疗程序)在经验丰富的应用情况下是一种安全可行且耐受性良好的程序。它能使体核温度快速上升且在平台期具有高热稳定性。在所有治疗阶段都能全面接触患者。

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