Tsuboi M, Nagai K, Saitoh H, Furukawa K, Konaka C, Kato H, Kawana K, Abe K
Department of Surgery, Tokyo Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Aug;40(8):1195-202.
Local hyperthermochemotherapy was performed in 17 cases to control malignant effusion and intrathoracic disseminated lesions. Of these 15 patients, 11 cases primary lung cancer, 4 cases metastatic lung cancer had pleural carcinomatosis and 2 cases were malignant diffuse mesotheliomas. The procedure was radiofrequency hyperthermia (13.56 MHz) maintaining the peripleural temperature at 42-43 degrees C for 45-60 minutes, combined simultaneously with the intrathoracic administration of cisplatin (1-2 mg/m2, bolus) through a thoracic double lumen trocar tube. The treatment was repeated from 2 to 4 times at 7-day intervals. In 14 cases (87.5%) complete or partial response according to the criteria of the Japan Lung Cancer Society were obtained. There were 2 cases of no change and one case that was impossible to evaluate. In one lung cancer case, the disappearance of pleural disseminated lesions was confirmed by flexible thoracoscopy after the procedure. In 12 cases, there were abdominal complaints due to side effects of the hyperthermochemotherapy, such as vomiting and nausea, but these symptoms were milder than those caused by intravenous injection of anti-cancer agents, for example cisplatin, in conventional chemotherapy treatment. The median survival time and 2 years survival of the patients with the present procedure were 15 months and 41.7% respectively. Although distant metastases appeared in most cases, none had local recurrence and particularly noteworthy pleural effusion was well controlled. The above experience suggested that the local hyperthermochemotherapy is useful to control pleural effusion and can improve the quality of life of patients with pleural carcinomatosis.
对17例患者进行了局部热化疗以控制恶性胸腔积液和胸内播散性病变。这15例患者中，11例为原发性肺癌，4例转移性肺癌合并胸膜癌病，2例为恶性弥漫性间皮瘤。治疗方法为射频热疗（13.56MHz），将胸膜周围温度维持在42 - 43摄氏度45 - 60分钟，同时通过胸双腔套管针向胸腔内注入顺铂（1 - 2mg/m²，静脉推注）。治疗每隔7天重复2至4次。根据日本肺癌协会标准，14例（87.5%）患者获得完全或部分缓解。2例病情无变化，1例无法评估。1例肺癌患者在治疗后经可弯曲胸腔镜证实胸膜播散性病变消失。12例患者出现热化疗副作用引起的腹部不适，如呕吐和恶心，但这些症状比传统化疗中静脉注射抗癌药物（如顺铂）引起的症状轻。采用本治疗方法的患者中位生存时间和2年生存率分别为15个月和41.7%。虽然大多数病例出现远处转移，但无一例出现局部复发，尤其值得注意的是胸腔积液得到了很好的控制。上述经验表明，局部热化疗有助于控制胸腔积液，可提高胸膜癌病患者的生活质量。
