De Leeuw A A C, Van Vulpen M, Van De Kamer J B, Wárlám-Rodenhuis C C, Lagendijk J J W
Department of Radiotherapy, HP Q.00.118, University Medical Center Utrecht, Postbus 8500, 3508 GA Utrecht, The Netherlands.
Int J Hyperthermia. 2003 Nov-Dec;19(6):655-63. doi: 10.1080/02656730310001594378.
In the application of regional hyperthermia, optimization of the temperature distribution remains necessary. One of the tools that might be used is a modest increase in the systemic temperature to diminish cooling by blood perfusion. This study investigates (1) if it is feasible to increase the systemic temperature by applying other cooling strategies, without inducing unacceptable systemic stress, and (2) whether a rise in systemic temperature results in improvement of tumour temperatures. Eleven patients with locally advanced cervical carcinoma and 12 patients with locally advanced prostate carcinoma were treated with our Coaxial TEM regional hyperthermia system. In this system, the temperature of the open water bolus can be easily adjusted. Two cooling methods were applied alternately, one with a relatively low water temperature (method A), the other with a higher water bolus temperature in combination with extensive head/chest cooling by a hand shower (method B). Method B resulted in significantly higher systemic temperatures, for both patient groups separately (0.8, respectively, 0.5 degrees C) and for the total patient group (0.7 degrees C). Additionally, all tumour index temperatures were higher. For the combined group (for T50: 0.4 degrees C) and for the cervix group (for T50: 0.7 degrees C), it reached statistical significance. The raise in core temperature led to a significantly higher increase in heart rate. For the group of cervix patients, higher systemic temperatures resulted in more treatment-limiting systemic stress. For the prostate patients, systemic stress was not an important issue. Since the raise in systemic temperature did not influence the overall tolerance of treatment, method B could be applied to this group. However, the increases in tumour temperatures were small, and potential hazards of systemic temperature increase should be considered.
在区域热疗的应用中，温度分布的优化仍然是必要的。一种可能使用的方法是适度提高全身温度以减少血液灌注带来的冷却效应。本研究调查了：（1）通过应用其他冷却策略提高全身温度而不引起不可接受的全身应激是否可行；（2）全身温度升高是否会导致肿瘤温度的改善。11例局部晚期宫颈癌患者和12例局部晚期前列腺癌患者接受了我们的同轴TEM区域热疗系统治疗。在该系统中，开放水囊的温度可以很容易地调节。交替应用两种冷却方法，一种是水温相对较低的方法（方法A），另一种是水囊温度较高并结合手持淋浴对头/胸部进行广泛冷却的方法（方法B）。方法B导致两组患者各自的全身温度显著升高（分别为0.8℃和0.5℃），总患者组升高了0.7℃。此外，所有肿瘤指标温度也更高。对于联合组（T50升高0.4℃）和宫颈癌组（T50升高0.7℃），达到了统计学显著性。核心温度的升高导致心率显著加快。对于宫颈癌患者组，较高的全身温度导致更多限制治疗的全身应激。对于前列腺癌患者，全身应激不是一个重要问题。由于全身温度升高不影响治疗的总体耐受性，方法B可应用于该组。然而，肿瘤温度的升高幅度较小，应考虑全身温度升高的潜在危害。
