Gillette S M, Dewhirst M W, Gillette E L, Thrall D E, Page R L, Powers B E, Withrow S J, Rosner G, Wong C, Sim D A
Department of Radiology and Radiation Biology, Colorado State University, Fort Collins 80523.
Int J Hyperthermia. 1992 May-Jun;8(3):309-20. doi: 10.3109/02656739209021786.
Sixty-four dogs with spontaneous soft tissue sarcomas without evidence of metastases were stratified by tumour volume and randomized to receive graded doses of radiotherapy (XRT) alone or radiotherapy plus hyperthermia (HT). An improvement in duration of local control was achieved with the addition of hyperthermia as compared with XRT alone (Wilcoxon, p = 0.040; log rank, p = 0.064). Overall frequency of late complications was not different for the two treatment arms when comparing across equivalent XRT dose groups. Frequency of distant metastases after therapy completion was not significantly different for the two treatment arms at 1 year (7.4% for XRT versus 20% for HT plus XRT) or 2 years (11.5% for XRT versus 25% for HT plus XRT) post therapy. These results suggest that a therapeutic gain was achieved for this group of tumour-bearing animals. Uni- and multivariate analyses were performed to examine the potential for various factors to influence treatment outcome. Patient related variables included tumour stage, histologic subtype and grade and tumour site. Treatment related variables included total radiation dose and 15 descriptors of temperature distributions achieved during hyperthermia. When considering patient related factors, tumour histology, grade and location were important predictors of time to minimum volume, but only tumour location influenced time to tumour regrowth. When considering treatment related factors, radiation dose was not significantly correlated with time to minimum volume or time to local regrowth, but it was correlated with probability for late normal tissue damage in the XRT alone group (p = 0.005). For the hyperthermia treatments, 13 of 15 tumour temperature distribution descriptors were correlated with time to minimum volume, but none were correlated with time to local regrowth. These results suggest that caution should be used in interpreting the value of temperature distribution descriptors in predicting for long-term local control after hyperthermia and radiotherapy, based on analysis of short-term responses.
64只患有自发性软组织肉瘤且无转移迹象的犬，根据肿瘤体积进行分层，并随机分为单独接受分级剂量放疗（XRT）或放疗加高温治疗（HT）两组。与单纯XRT相比，添加高温治疗可改善局部控制的持续时间（Wilcoxon检验，p = 0.040；对数秩检验，p = 0.064）。在比较等效XRT剂量组时，两个治疗组的晚期并发症总发生率没有差异。治疗完成后1年（XRT组为7.4%，HT加XRT组为20%）或2年（XRT组为11.5%，HT加XRT组为25%）时，两个治疗组远处转移的发生率没有显著差异。这些结果表明，对于这组荷瘤动物实现了治疗获益。进行了单因素和多因素分析，以研究各种因素影响治疗结果的可能性。患者相关变量包括肿瘤分期、组织学亚型、分级和肿瘤部位。治疗相关变量包括总辐射剂量以及高温治疗期间获得的15个温度分布描述指标。在考虑患者相关因素时，肿瘤组织学、分级和位置是达到最小体积时间的重要预测因素，但只有肿瘤位置影响肿瘤再生长时间。在考虑治疗相关因素时，辐射剂量与达到最小体积时间或局部再生长时间没有显著相关性，但与单纯XRT组晚期正常组织损伤的概率相关（p = 0.005）。对于高温治疗，15个肿瘤温度分布描述指标中有13个与达到最小体积时间相关，但均与局部再生长时间无关。这些结果表明，基于短期反应分析，在解释温度分布描述指标对高温治疗和放疗后长期局部控制的预测价值时应谨慎。
