Seegenschmiedt M H, Sauer R, Fietkau R, Iro H, Chalal J A, Brady L W
Department of Therapeutic Radiology, Universität Erlangen-Nurnberg, Germany.
Radiology. 1992 Sep;184(3):795-804. doi: 10.1148/radiology.184.3.1509070.
Sixty-two patients with 24 primary advanced, six persistent, 28 locally recurrent, and four metastatic tumors of the head and neck were treated with combined interstitial low-dose iridium-192 radiation therapy, interstitial 915-MHz microwave hyperthermia (IHT), and external-beam radiation therapy. Diagnoses were squamous cell carcinoma in 56, adenocarcinoma in three, and soft-tissue sarcoma in three lesions. IHT was applied immediately before Ir-192 was placed and after its removal for 45-60 minutes at 41 degrees C-44 degrees C. At 3 months, complete remission had occurred in 39 lesions; partial remission, in 18; and no change or progressive disease, in five. At 12-month follow-up, local control was achieved in 29 of 50 patients; seven other patients had slow ongoing tumor regression with an unclear residual mass at computed tomography or magnetic resonance imaging. Lesion type, tumor volume, total radiation dose, and thermal parameters with "good quality of heating" at high minimum tumor temperature were identified as statistically significant (P less than .05) prognostic factors influencing initial and long-term tumor response. There was no prognostic factor for acute or late thermal damage.
62例患有24例原发性晚期、6例持续性、28例局部复发性和4例头颈部转移性肿瘤的患者接受了间质低剂量铱-192放射治疗、间质915兆赫微波热疗（IHT）和外照射放疗联合治疗。诊断结果为56例鳞状细胞癌、3例腺癌和3例软组织肉瘤。IHT在放置Ir-192之前以及移除后立即应用，在41摄氏度至44摄氏度下持续45至60分钟。3个月时，39个病灶完全缓解；18个部分缓解；5个无变化或疾病进展。在12个月的随访中，50例患者中有29例实现了局部控制；其他7例患者肿瘤持续缓慢消退，计算机断层扫描或磁共振成像显示残留肿块不明确。病变类型、肿瘤体积、总辐射剂量以及在高最低肿瘤温度下具有“良好加热质量”的热参数被确定为影响初始和长期肿瘤反应的统计学显著（P小于0.05）预后因素。没有急性或晚期热损伤的预后因素。
