Seegenschmiedt H M, Karlsson U L, Sauer R, Brady L W, Herbst M, Amendola B E, Markoe A M, Fisher S A, Micaily B
Strahlentherapeutische Universitätsklinik, Universität Erlangen-Nürnberg, Federal Republic of Germany.
Radiology. 1989 Nov;173(2):551-8. doi: 10.1148/radiology.173.2.2477869.
Forty-nine patients with chest wall recurrences of breast carcinoma received radiation therapy and 915-MHz microwave hyperthermia for 95 lesions. Follow-up ranged from 3 to 39 months, with five patients dying before 6 months follow-up. At 1 month follow-up, 49 (52%) of 95 lesions showed complete response; 28 (29%), partial response; and 18 (19%), no change. At 6 or more months follow-up, 54 (67%) of 81 lesions demonstrated local control; 10 (12%), partial response; six (7%), no change; and 11 (14%), local-regional recurrences. Superficial blisters occurred in 24 (25%) of 95 lesions, whereas long-term complications (deep necrosis, subcutaneous burns) occurred in seven (7%) lesions. Relapse occurred in 16 (17%) lesions, seven after initial complete response and nine after partial response. Several prognostic treatment factors were identified: applied radiation dose (greater than 30 Gy, P less than .01), size of tumor (less than 6 cm diameter, P less than .001), minimum tumor temperature (greater than 41 degrees C, P less than .001), and status of disease (M0 or M1 vs M2, P less than .001). Treatment complications were correlated with maximum temperatures (greater than 45 degrees C, P less than .001). In summary the palliative treatment concept proved to be safe and effective.
49例乳腺癌胸壁复发患者接受了放射治疗和915兆赫微波热疗，共治疗95个病灶。随访时间为3至39个月，5例患者在随访6个月前死亡。在1个月的随访中，95个病灶中有49个（52%）显示完全缓解；28个（29%）部分缓解；18个（19%）无变化。在6个月或更长时间的随访中，81个病灶中有54个（67%）显示局部控制；10个（12%）部分缓解；6个（7%）无变化；11个（14%）局部区域复发。95个病灶中有24个（25%）出现浅表水泡，而7个（7%）病灶出现长期并发症（深部坏死、皮下烧伤）。16个（17%）病灶复发，7个在最初完全缓解后复发，9个在部分缓解后复发。确定了几个预后治疗因素：应用的放射剂量（大于30 Gy，P小于0.01）、肿瘤大小（直径小于6 cm，P小于0.001）、最低肿瘤温度（大于41℃，P小于0.001）和疾病状态（M0或M1与M2，P小于0.001）。治疗并发症与最高温度相关（大于45℃，P小于0.001）。总之，姑息治疗概念被证明是安全有效的。
