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局部热疗联合外照射治疗局部复发性乳腺癌。

Local hyperthermia combined with external irradiation for regional recurrent breast carcinoma.

作者信息

Li Gong, Mitsumori Michihide, Ogura Masakazu, Horii Naotoshi, Kawamura Sachiko, Masunaga Shin-ichiro, Nagata Yasushi, Hiraoka Masahiro

机构信息

Department of Therapeutic Radiology and Oncology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.

出版信息

Int J Clin Oncol. 2004 Jun;9(3):179-83. doi: 10.1007/s10147-004-0395-3.

Abstract

BACKGROUND

The purpose of this study was to evaluate the therapeutic effects of hyperthermia in combination with radiotherapy for locoregional recurrence of breast cancer, and to assess the factors related to subsequent local tumor control.

METHODS

Between March 1981 and February 2001, 85 lesions in 73 patients were treated with local hyperthermia combined with external irradiation. Of 75 evaluable lesions, 41 were previously irradiated. Mean radiation dose to the previously unirradiated area was 59.5 +/- 6.8 Gy (range, 40-70 Gy), while a total dose of 43.0 +/- 12.4 Gy (range, 12-74.4 Gy) was administered to previously irradiated tumors. Hyperthermia was administered once or twice per week. The average number of hyperthermia sessions was 4.5 (2-9).

RESULTS

Complete responses (CRs) were achieved in 56% (23/41) of previously irradiated and 47% (16/34) of unirradiated tumors. There was no significant difference in the CR rate between the two groups. Compared with the response of bulky/nodular tumors, diffuse/multiple small nodular tumors showed a higher CR rate at 4 weeks after treatment. However, at 6 months after treatment, they showed a significantly lower local control rate.

CONCLUSIONS

The present findings suggested a significant benefit of local hyperthermia combined with radiotherapy in the treatment of locally recurrent breast cancer, especially for previously irradiated recurrence, by reducing the total irradiation dose. Diffuse/multiple small nodular tumors respond earlier than bulky/large nodular tumors; however, they tend to recur within the treatment field. The purpose of this study was to evaluate the therapeutic effects of hyperthermia in combination with radiotherapy for locoregional recurrence of breast cancer, and to assess the factors related to subsequent local tumor control.

摘要

背景

本研究旨在评估热疗联合放疗对乳腺癌局部区域复发的治疗效果,并评估与后续局部肿瘤控制相关的因素。

方法

1981年3月至2001年2月期间,对73例患者的85个病灶采用局部热疗联合外照射治疗。在75个可评估病灶中,41个曾接受过照射。既往未照射区域的平均放射剂量为59.5±6.8 Gy(范围40 - 70 Gy),而既往接受过照射的肿瘤给予的总剂量为43.0±12.4 Gy(范围12 - 74.4 Gy)。热疗每周进行一次或两次。热疗的平均次数为4.5次(2 - 9次)。

结果

既往接受过照射的肿瘤中56%(23/41)达到完全缓解(CR),未接受过照射的肿瘤中47%(16/34)达到完全缓解。两组的CR率无显著差异。与体积较大/结节状肿瘤的反应相比,弥漫性/多个小结节状肿瘤在治疗后4周时CR率较高。然而,在治疗后6个月时,它们的局部控制率显著较低。

结论

目前的研究结果表明,局部热疗联合放疗在治疗局部复发性乳腺癌方面具有显著益处,尤其是对于既往照射后复发的情况,可降低总照射剂量。弥漫性/多个小结节状肿瘤比体积较大/大结节状肿瘤反应更早;然而,它们倾向于在治疗区域内复发。本研究旨在评估热疗联合放疗对乳腺癌局部区域复发的治疗效果,并评估与后续局部肿瘤控制相关的因素。

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