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[采用植入式加热系统对恶性胶质瘤进行间质热疗]

[Interstitial hyperthermia of malignant gliomas with implant heating system].

作者信息

Kida Y, Mori Y, Hattori T, Kobayashi T

机构信息

Department of Neurosurgery, Komaki City Hospital.

出版信息

No Shinkei Geka. 1990 Nov;18(11):1007-14.

PMID:2247193
Abstract

Twenty four cases of malignant gliomas, histologically 12 glioblastomas, 10 astrocytoma GIII and 2 astrocytoma GII, were treated by interstitial hyperthermia with Implant Heating System (IHS). IHS has three major parts, generator of high frequency (240KHz), magnetic coil and metal implant manufactured from FePt alloy. Theoretically the brain tumor can be heated by heat conduction through the heated implants. Several implants were placed inside the brain tumor directly by operation, or by CT stereotactic procedure. The patients were divided into two groups according to the tumor location as (A) in cortical or subcortical region (13 cases) and (B) in thalamus or basal ganglia (11 cases). Hyperthermia, 60 minutes each, 2 to 3 times per week, was safely repeated in all the cases. External irradiation was always combined with hyperthermia in most of the cases and with chemotherapy in some of them. Follow-up CTs demonstrate a remarkable response in many cases of B group. In fact ICR, 4PR and 3MR were achieved in this group, resulting in 45.5% of the response. In contrast gliomas in A group showed a less favorable response, resulting in 23.1% of the response (3 PRs in 13 cases). Although the overall response rate was not so high, it seems to be encouraging that gliomas in thalamus and basal ganglia, those which are usually unresectable, showed a good response. More favorable results can be expected by further improvement of the system and related techniques.

摘要

24例恶性胶质瘤患者,组织学检查显示12例胶质母细胞瘤、10例III级星形细胞瘤和2例II级星形细胞瘤,采用植入式加热系统(IHS)进行间质热疗。IHS有三个主要部分,高频(240KHz)发生器、磁线圈和由FePt合金制成的金属植入物。理论上,脑肿瘤可通过加热植入物的热传导来加热。通过手术或CT立体定向程序将多个植入物直接放置在脑肿瘤内。根据肿瘤位置将患者分为两组:(A)皮质或皮质下区域(13例)和(B)丘脑或基底神经节(11例)。所有病例均安全地重复进行热疗,每次60分钟,每周2至3次。在大多数病例中,外照射总是与热疗联合使用,在一些病例中与化疗联合使用。随访CT显示B组的许多病例有显著反应。事实上,该组实现了4例完全缓解(CR)、4例部分缓解(PR)和3例疾病稳定(MR),缓解率为45.5%。相比之下,A组的胶质瘤反应较差,缓解率为23.1%(13例中有3例PR)。尽管总体缓解率不高,但丘脑和基底神经节的胶质瘤通常无法切除,却显示出良好的反应,这似乎令人鼓舞。通过进一步改进系统和相关技术,有望获得更理想的结果。

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