Advanced Centre for Radiation Oncology, Dr Balabhai Nanavati Hospital, Mumbai 400056, India.
Int J Hyperthermia. 2010 Feb;26(1):21-5. doi: 10.3109/02656730903418283.
The management of head and neck cancer requires skilled integration of multiple modalities such as surgery, radiation, chemotherapy and hyperthermia. Chemoradiation can benefit from the addition of a proven modality such as hyperthermia in increasing survival, disease-free survival and quality of life without increasing the risk of complication. The purpose of this retrospective study was to evaluate the feasibility and efficacy of hyperthermia with chemoradiation in advanced head and neck cancers.
Between January 2004 and May 2008 40 patients with advanced head and neck cancers were allocated for hyperthermia with chemoradiotherapy. All patients underwent radiation on a telecobalt machine. A total dose of 70 Gy in 7 weeks with conventional fractionation was given with weekly chemotherapy of cisplatin 50 mg or paclitaxel 60 mg. Patients underwent hyperthermia on a radiofrequency machine at 8.2 MHz for 30 min at 41 degrees -43 degrees C with 10 min pre-cooling to 5 degrees C.
No patient had life-threatening complications. Only 38 out of 40 patients were eligible for assessment of immediate response as one patient died during treatment and the other did not complete treatment. Complete response was 76.23% (29 pts), and 23.68% (9 pts) had partial response. Overall survival by the Kaplan-Meir method was 75.69% at 1 year and 63.08% at 2 years. No enhanced mucosal or thermal toxicities were documented as compared to our earlier experience with chemoradiation.
This retrospective analysis demonstrates the feasibility and efficacy of chemoradiation with hyperthermia in advanced head and neck cancer. The study is encouraging enough to start a randomised trial to compare chemoradiation with triple modality of treatment.
头颈部癌症的治疗需要多种治疗手段的综合应用,如手术、放疗、化疗和热疗。放化疗可受益于增加一种已被证实的治疗手段,如热疗,以提高生存率、无病生存率和生活质量,而不增加并发症的风险。本回顾性研究的目的是评估头颈部晚期癌症患者热疗联合放化疗的可行性和疗效。
2004 年 1 月至 2008 年 5 月,40 例晚期头颈部癌症患者被分配接受热疗联合放化疗。所有患者均在钴-60 机上接受放疗。常规分割,每周给予顺铂 50mg 或紫杉醇 60mg 化疗,7 周内共给予 70Gy 剂量。患者在射频机上以 8.2MHz 进行热疗,41-43°C 下 30 分钟,10 分钟预冷至 5°C。
无患者发生危及生命的并发症。由于 1 例患者在治疗期间死亡,另 1 例患者未完成治疗,因此仅 40 例患者中的 38 例可评估即时反应。完全缓解率为 76.23%(29 例),部分缓解率为 23.68%(9 例)。Kaplan-Meier 方法的 1 年总生存率为 75.69%,2 年总生存率为 63.08%。与我们之前的放化疗经验相比,未见黏膜或热毒性增强。
本回顾性分析表明,热疗联合放化疗治疗晚期头颈部癌症是可行和有效的。该研究结果令人鼓舞,足以开展一项随机试验,比较放化疗与三联治疗模式。