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对接受放疗与热疗联合治疗的患者肿瘤反应的回顾性分析。

Retrospective analysis of the response of tumours in patients treated with a combination of radiotherapy and hyperthermia.

作者信息

Van der Zee J, Van Putten W L, Van den Berg A P, Van Rhoon G C, Hooley J L, Broekmeyer-Reurink M P, Reinhold H S

出版信息

Int J Hyperthermia. 1986 Oct-Dec;2(4):337-49. doi: 10.3109/02656738609004964.

Abstract

One hundred and twelve patients with various carcinomas were treated on 112 fields with radiotherapy and hyperthermia, using non-invasive techniques. Radiotherapy dose ranged from 13-70 Gy (except for one patient receiving hyperthermia alone) with a mean of 28.6 Gy. The combined treatment was primarily aimed at giving palliation; 79 per cent of the patients had received previous irradiation on the same area. Hyperthermia was given twice weekly following radiotherapy. From the temperature data collected, 12 different parameters expressing the hyperthermia 'dose' were derived. The various parameters for both treatment modalities, i.e. radiotherapy and hyperthermia, and some of the tumour parameters were statistically evaluated with respect to their influence on tumour response. The overall response rate was 87 per cent including 33 per cent complete response. The complete response rate increased with increasing radiotherapy total dose, i.e. from 23 per cent (14-25 Gy) and 38 per cent (28-36 Gy) to 60 per cent (greater than 38 Gy). A positive correlation between the tumour temperature parameter representative of the coldest spot in the tumour, and the level of response was found. Achievement of complete response appeared also to be determined to a considerable extent by radiotherapy total dose as well as tumour volume. The correlation between response level and the minimum hyperthermia dose parameters persisted, however, after correction for the influence of tumour volume and radiotherapy total dose. These results support the opinion that higher tumour response rates can be achieved by increasing the hyperthermia treatment level at the coldest spot in the tumour.

摘要

112例患有各种癌症的患者在112个野上接受了放疗和热疗,采用非侵入性技术。放疗剂量范围为13 - 70Gy(除1例仅接受热疗的患者外),平均剂量为28.6Gy。联合治疗主要旨在缓解症状;79%的患者此前在同一部位接受过放疗。放疗后每周进行两次热疗。根据收集到的温度数据,得出了12个表示热疗“剂量”的不同参数。对放疗和热疗这两种治疗方式的各种参数以及一些肿瘤参数对肿瘤反应的影响进行了统计学评估。总体缓解率为87%,其中完全缓解率为33%。完全缓解率随放疗总剂量的增加而升高,即从23%(14 - 25Gy)和38%(28 - 36Gy)增至60%(大于38Gy)。发现肿瘤中代表最冷部位的温度参数与反应水平之间存在正相关。完全缓解的实现似乎在很大程度上也取决于放疗总剂量和肿瘤体积。然而,在校正肿瘤体积和放疗总剂量的影响后,反应水平与最低热疗剂量参数之间的相关性仍然存在。这些结果支持这样一种观点,即通过提高肿瘤最冷部位的热疗水平可以实现更高的肿瘤反应率。

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