Kodama K, Doi O, Tatsuta M, Kuriyama K, Tateishi R
Department of Thoracic Surgery, Center for Adult Diseases, Osaka, Japan.
Cancer. 1989 Oct 1;64(7):1422-8. doi: 10.1002/1097-0142(19891001)64:7<1422::aid-cncr2820640710>3.0.co;2-t.
From April 1985 through March 1988, 24 lung cancer patients with carcinomatous pleuritis were treated with a new combined treatment modality consisting of pulmonary resection and postoperative intrathoracic chemo-thermotherapy (PICT). They consisted of 15 male patients and nine female patients. A majority of the patients (79%%) had adenocarcinoma. The PICT was started 10 to 14 days after the operation. Immediately after a bolus intrathoracic injection of cisplatin (CDDP) 50-100 mg, thermotherapy was carried out using 13.56-MHz or 8.00-MHz radiofrequency waves for 60 minutes. The peripleural temperature was precisely monitored in 20 patients. The temperature was successfully maintained above 42 degrees C for 40 minutes in each of two or three treatment courses in 13 patients, with no complications. However, in the other seven patients the therapy resulted in incomplete treatment because of development of a side effect. Cytologic examination of the pleural effusion, which was performed after the completion of PICT, gave a negative result in 16 of 20 patients examined. The median follow-up period was 16 months. Local relapse was recognized in only three cases who received incomplete treatment or in whom no temperature measurement was performed. The overall survival of the treated patients (n = 24) was significantly prolonged in comparison with a historical control group treated by surgery only (n = 17) or exploratory thoracotomy (n = 11). Of those 17 patients treated by surgery only, ten patients (59%) died of local relapse. These results suggest that this new treatment modality consisting of pulmonary resection and PICT is useful for the treatment of lung cancer patients with carcinomatous pleuritis, especially in the light of improved local control.
1985年4月至1988年3月期间，对24例患有癌性胸膜炎的肺癌患者采用了一种新的联合治疗方法，该方法包括肺切除和术后胸内化学热疗（PICT）。其中男性患者15例，女性患者9例。大多数患者（79%）患有腺癌。PICT在术后10至14天开始。在胸腔内一次性注射50 - 100毫克顺铂（CDDP）后，立即使用13.56兆赫兹或8.00兆赫兹的射频波进行60分钟的热疗。对20例患者精确监测了胸膜周围温度。13例患者在两三个疗程中，每次均成功将温度维持在42摄氏度以上40分钟，且无并发症。然而，另外7例患者因出现副作用导致治疗不彻底。在完成PICT后进行的胸腔积液细胞学检查中，20例接受检查的患者中有16例结果为阴性。中位随访期为16个月。仅在3例接受不完全治疗或未进行温度测量的患者中发现局部复发。与仅接受手术治疗的历史对照组（n = 17）或 exploratory thoracotomy（n = 11）相比，接受治疗的患者（n = 24）的总生存期显著延长。在仅接受手术治疗的17例患者中，有10例（59%）死于局部复发。这些结果表明，这种由肺切除和PICT组成的新治疗方法对于治疗患有癌性胸膜炎的肺癌患者是有用的，特别是从改善局部控制的角度来看。
