Matsumine Akihiko, Kusuzaki Katsuyuki, Matsubara Takao, Shintani Ken, Satonaka Haruhiko, Wakabayashi Toru, Miyazaki Shinichi, Morita Katsuya, Takegami Kenji, Uchida Atsumasa
Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu-city, 514-8507, Japan.
Clin Exp Metastasis. 2007;24(3):191-200. doi: 10.1007/s10585-007-9068-8. Epub 2007 May 9.
We have developed a novel hyperthermic treatment modality using magnetic materials for metastatic bone tumors. The purpose of this study is to show the results of novel hyperthermia for metastatic bone tumors. This novel hyperthermic treatment modality was used for 15 patients with 16 metastatic bone lesions. In seven lesions, after curettage of the metastatic lesion followed by reinforcement with a metal intramedullary nail or plate, calcium phosphate cement (CPC) containing powdery Fe3O4 was implanted into the cavity. In one lesion, prosthetic reconstruction was then performed after an intralesional tumor excision. For the remaining eight lesions, metal intramedullary nails were inserted into the affected bone. Hyperthermic therapy was started at 1 week postoperatively. To comparatively evaluate the radiographic results of patients who underwent hyperthermia (HT group), we also assessed eight patients who received a palliative operation without either radiotherapy or hyperthermia (Op group), and 22 patients who received operation in combination with postoperative radiotherapy (Op + RT group). In HT group, all patients had an acceptable limb function with pain relief without any complications. On radiographs, 87, 38, and 91% were, respectively, considered to demonstrate an effective treatment outcome in HT group, Op group, and Op + RT group. The patients in HT group showed a statistically better radiographic outcome than the patients in Op group (P = 0.0042). But when compared between HT group and Op + RT group, there were no significant difference (P = 0.412). This first series of clinical hyperthermia using magnetic materials achieved good local control of metastatic bone lesion.
我们开发了一种使用磁性材料治疗转移性骨肿瘤的新型热疗方法。本研究的目的是展示新型热疗治疗转移性骨肿瘤的结果。这种新型热疗方法用于15例患有16处转移性骨病变的患者。在7处病变中,在刮除转移性病变并用金属髓内钉或钢板加固后,将含有粉末状Fe3O4的磷酸钙骨水泥(CPC)植入腔内。在1处病变中,在病灶内肿瘤切除后进行假体重建。对于其余8处病变,将金属髓内钉插入患骨。热疗在术后1周开始。为了比较评估接受热疗患者(热疗组)的影像学结果,我们还评估了8例接受姑息性手术但未接受放疗或热疗的患者(手术组),以及22例接受手术并结合术后放疗的患者(手术 + 放疗组)。在热疗组中,所有患者肢体功能均可接受,疼痛缓解,无任何并发症。在X线片上,热疗组、手术组和手术 + 放疗组分别有87%、38%和91%被认为显示出有效的治疗结果。热疗组患者的影像学结果在统计学上优于手术组患者(P = 0.0042)。但热疗组与手术 + 放疗组相比,无显著差异(P = 0.412)。这第一系列使用磁性材料的临床热疗对转移性骨病变实现了良好的局部控制。