Huilgol Nagraj G, Gupta Sapna, Sridhar C R
Department of Radiation Oncology, Dr. Balabhai Nanavati Hospital, Mumbai, India.
J Cancer Res Ther. 2010 Oct-Dec;6(4):492-6. doi: 10.4103/0973-1482.77101.
Head and neck cancer is the leading cause of male mortality due to cancer in India. Surgery, radiation alone or in combination has been the backbone of treatment strategies. Chemo-radiation has emerged as the standard of care in most types of head and neck cancer. This strategy has the advantage of maintaining both structure and functions, albeit with increased acute and delayed side effects. Radiation with hyperthermia can achieve the same objective without additional toxicities.
A total of 56 patients were randomized to radiation therapy (RT) alone or RT-hyperthermia (RT-HT) arm. Twenty-six patients were included in RT alone arm and 28 patients in the RT-HT arm. Both groups were evenly matched for age, sex, and stage. Patients in both the arms received radiation to a dose of 66-70 Gy in 6.5-7 weeks. Patients in the study group received weekly HT. HT was started after impedance matching to last for 30 minutes.
Complete response was seen in 42.4% of RT alone group compare to 78.6% in the HT group. The difference was statistically significant ( < 0.05). Kaplan-Meir analysis of survival also showed a significant improvement in favor of RT-HT. No dose limiting thermal burns and excessive mucosal or thermal toxicity were recorded.
Radiofrequency (RF) based heating and radical radiation of head and neck cancers is better than in RT alone group. HT should be considered as a valid option wherever the facility for HT is available. This report should infuse greater confidence in radiation Oncologists to practice HT as an adjuvant treatment modality.
在印度，头颈癌是男性癌症死亡的主要原因。手术、单纯放疗或联合放疗一直是治疗策略的核心。化疗放疗已成为大多数类型头颈癌的标准治疗方法。这种策略具有维持结构和功能的优势，尽管会增加急性和延迟副作用。热疗联合放疗可在不增加额外毒性的情况下达到相同目的。
共56例患者被随机分为单纯放疗组（RT）或放疗联合热疗组（RT-HT）。单纯放疗组纳入26例患者，放疗联合热疗组纳入28例患者。两组在年龄、性别和分期方面均衡匹配。两组患者均在6.5 - 7周内接受66 - 70 Gy的放疗。研究组患者每周接受热疗。热疗在阻抗匹配后开始，持续30分钟。
单纯放疗组的完全缓解率为42.4%，而热疗组为78.6%。差异具有统计学意义（<0.05）。生存的Kaplan-Meir分析也显示放疗联合热疗组有显著改善。未记录到剂量限制性热烧伤以及过度的黏膜或热毒性。
基于射频（RF）的加热联合头颈癌根治性放疗优于单纯放疗组。只要有热疗设备，热疗应被视为一种有效的选择。本报告应使放疗肿瘤学家更有信心将热疗作为一种辅助治疗方式应用。
