Radiation Oncology Department, Duke University, Durham, NC 27710, USA.
Int J Hyperthermia. 2010;26(7):686-98. doi: 10.3109/02656736.2010.501511.
This article summarises the evolution of microwave array applicators for heating large area chest wall disease as an adjuvant to external beam radiation, systemic chemotherapy, and potentially simultaneous brachytherapy.
Current devices used for thermotherapy of chest wall recurrence are reviewed. The largest conformal array applicator to date is evaluated in four studies: (1) ability to conform to the torso is demonstrated with a CT scan of a torso phantom and MR scan of the conformal water bolus component on a mastectomy patient; (2) specific absorption rate (SAR) and temperature distributions are calculated with electromagnetic and thermal simulation software for a mastectomy patient; (3) SAR patterns are measured with a scanning SAR probe in liquid muscle phantom for a buried coplanar waveguide CMA; and (4) heating patterns and patient tolerance of CMA applicators are characterised in a clinical pilot study with 13 patients.
CT and MR scans demonstrate excellent conformity of CMA applicators to contoured anatomy. Simulations demonstrate effective control of heating over contoured anatomy. Measurements confirm effective coverage of large treatment areas with no gaps. In 42 hyperthermia treatments, CMA applicators provided well-tolerated effective heating of up to 500 cm(2) regions, achieving target temperatures of T(min) = 41.4 ± 0.7°C, T(90) = 42.1 ± 0.6°C, T(ave) = 42.8 ± 0.6°C, and T(max) = 44.3 ± 0.8°C as measured in an average of 90 points per treatment.
The CMA applicator is an effective thermal therapy device for heating large-area superficial disease such as diffuse chest wall recurrence. It is able to cover over three times the treatment area of conventional hyperthermia devices while conforming to typical body contours.
本文总结了微波阵列适形器在辅助外照射、全身化疗和潜在同步近距离放疗治疗大面积胸壁疾病方面的发展历程。
回顾了目前用于胸壁复发热疗的设备。评估了迄今为止最大的适形阵列适形器，评估方法包括：（1）利用体模的 CT 扫描和乳房切除患者的适形水囊部分的磁共振扫描，展示对躯干的贴合能力；（2）利用电磁和热模拟软件，为乳房切除患者计算特定吸收率（SAR）和温度分布；（3）在液体肌肉模型中使用扫描 SAR 探头，对埋置共面波导 CMA 进行 SAR 模式测量；（4）在 13 例患者的临床初步研究中，对 CMA 适形器的加热模式和患者耐受性进行了描述。
CT 和磁共振扫描显示 CMA 适形器与轮廓解剖结构具有极好的贴合性。模拟结果表明能够有效控制加热对轮廓解剖结构的影响。测量结果证实可以有效地覆盖大面积的治疗区域，不存在间隙。在 42 次高温治疗中，CMA 适形器为 500cm2 区域提供了耐受良好且有效的加热，实现了 T(min) = 41.4±0.7°C、T(90) = 42.1±0.6°C、T(ave) = 42.8±0.6°C 和 T(max) = 44.3±0.8°C 的目标温度，每个治疗平均测量 90 个点。
CMA 适形器是一种有效的大面积表浅疾病热疗设备，如弥漫性胸壁复发。它能够覆盖常规热疗设备三倍以上的治疗面积，同时能够贴合典型的身体轮廓。
