Hitomi Jiro, Kubota Kei, Ogawa Yasuhiro, Hamada Norihiko, Murata Yoriko, Nishioka Akihito
Department of Radiology, Kochi Medical School, Kochi University, Kochi 783-8505, Japan.
Exp Ther Med. 2010 Sep;1(5):769-775. doi: 10.3892/etm.2010.123. Epub 2010 Jul 20.
The new enzyme-targeting radiosensitization treatment, Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, type II (KORTUC II), markedly enhances the radiotherapeutic effect of treatment for various types of locally advanced malignant neoplasms. Patients who had declined surgical treatment and systemic chemotherapy, as well as a total of 14 stage I breast cancer patients, were enrolled. A maximum of 6 ml of KORTUC II was injected into tumor tissue twice a week under ultrasonographic guidance, immediately prior to each administration of radiation therapy. The median observation period was 21.6 months with a range of 4-48 months, and the therapy was well tolerated. Contrast-enhanced magnetic resonance imaging and [(18)F]-fluorodeoxyglucose positron emission computed tomography revealed that all primary breast tumors completely responded, and none of the subjects experienced local recurrence during the observation period. Ultrasonography depicted tumor-like findings in 2/14 cases after therapy. The intratumoral flow signal on color-Doppler sonography was positive in 4/14 cases before therapy, and the signal disappeared from all cases after therapy. The absence of a flow signal after therapy suggested that the tumor-like findings on ultrasonography were from scar tissue. Excellent local control based on accurate radiological evaluation implies that KORTUC II has the potential to replace surgery as a therapeutic option for stage I breast cancer. Precise evaluation by various radiological modalities helped to gage the success of this therapy.
新型酶靶向放射增敏治疗,即高知过氧化氢放射治疗不可切除癌II型(KORTUC II),显著增强了对各种类型局部晚期恶性肿瘤的放射治疗效果。纳入了拒绝手术治疗和全身化疗的患者,以及总共14例I期乳腺癌患者。在每次放射治疗前,在超声引导下每周两次向肿瘤组织中注射最多6毫升KORTUC II。中位观察期为21.6个月,范围为4至48个月,该治疗耐受性良好。对比增强磁共振成像和[(18)F] - 氟脱氧葡萄糖正电子发射计算机断层扫描显示,所有原发性乳腺肿瘤均完全缓解,且在观察期内无一例患者出现局部复发。超声检查显示治疗后14例中有2例出现类似肿瘤的表现。彩色多普勒超声检查显示治疗前14例中有4例瘤内血流信号为阳性,治疗后所有病例信号均消失。治疗后血流信号消失表明超声检查中类似肿瘤的表现来自瘢痕组织。基于准确的放射学评估实现的出色局部控制意味着KORTUC II有可能替代手术,作为I期乳腺癌的一种治疗选择。通过各种放射学检查手段进行的精确评估有助于衡量该治疗的成功与否。