Petrovich Z, Langholz B, Kapp D S, Emami B, Oleson J R, Luxton G, Astrahan M
University of Southern California, Department of Radiation Oncology, Los Angeles 90033.
Am J Clin Oncol. 1989 Oct;12(5):378-83. doi: 10.1097/00000421-198910000-00003.
From 1981 to 1986, six medical centers participated in feasibility studies of radiofrequency deep regional hyperthermia (HT) in the treatment of hepatic metastases. A total of 49 patients, 32 men and 17 women, were treated with an annular phased array. Colon was the primary site in 74% of the patients, and adenocarcinoma was the diagnosis in 80%. More than one half of the patients had been treated previously. This included chemotherapy (CT) in 17 patients and radiotherapy (RT) in 10 patients, with a mean RT dose of 24 Gy. Upper abdominal pain was the dominant presenting symptom in 53% of patients. In the study, treatment was administered as follows: 14 (28%) patients received HT alone, 17 (35%) received HT + RT, 14 (28%) received HT + CT, and 4 (8%) received HT + RT + CT. A total of 157 HT treatments was administered at a mean frequency of 55 MHz and a mean power of 780 watts. The number of HT sessions ranged from 1 to 8, with a mean of 3.2 treatments per patient. Temperature was monitored continuously throughout each treatment session. The treatment aim was to reach and maintain a temperature of 42.5 degrees C for 30 min. In practice, owing to the difficulty in reaching this temperature, an equivalent (lower) temperature from 40 to 42 degrees C was used, extending the duration of treatment sessions to 45-60 min. Thermal dose was defined as the number of minutes at 42.5 degrees C or its equivalent. In 21 (43%) patients, a temperature less than 40 degrees C was obtained and thermal dose = 0. Thermal dose was less than or equal to 50 in 17 (35%) patients, greater than 50 less than or equal to 100 in 7 (14%), and greater than 100 in 4 (8%). RT was given at a daily dose of 1.8 Gy to a total of less than 20 Gy in 14 patients, greater than 20 less than or equal to 30 Gy in 6, and greater than 30 Gy in 1. CT consisted of 5-Fluorouracil by way of Hepatic Artery Infusion (HAI) in 9 patients, i.v. cisplatin in 5, and doxorubicin HAI in 3. Objective tumor regression (CR + PR) was seen in 6 (12%) patients. An additional 10 (20%) patients had less than 50% greater than 25% tumor regression, and 10 (20%) had complete or partial pain relief. The median duration of CR and PR was 26 weeks.(ABSTRACT TRUNCATED AT 400 WORDS)
1981年至1986年期间，六个医学中心参与了射频深部区域热疗（HT）治疗肝转移瘤的可行性研究。共有49例患者，其中男性32例，女性17例，接受了环形相控阵治疗。74%的患者原发部位为结肠，80%的患者诊断为腺癌。超过一半的患者此前接受过治疗，其中17例接受过化疗（CT），10例接受过放疗（RT），放疗平均剂量为24 Gy。上腹部疼痛是53%患者的主要症状。在该研究中，治疗方式如下：14例（28%）患者仅接受热疗，17例（35%）接受热疗+放疗，14例（28%）接受热疗+化疗，4例（8%）接受热疗+放疗+化疗。共进行了157次热疗，平均频率为55 MHz，平均功率为780瓦。热疗疗程数为1至8次，每位患者平均治疗3.2次。每次治疗过程中持续监测体温。治疗目标是达到并维持42.5摄氏度的体温30分钟。实际上，由于难以达到该温度，采用了40至42摄氏度的等效（较低）温度，将治疗疗程延长至45 - 60分钟。热剂量定义为在42.5摄氏度或其等效温度下的分钟数。21例（43%）患者体温低于40摄氏度，热剂量=0。17例（35%）患者热剂量小于或等于50，7例（14%）患者热剂量大于50小于或等于100，4例（8%）患者热剂量大于100。14例患者放疗每日剂量为1.8 Gy，总量小于20 Gy；6例患者总量大于20小于或等于30 Gy；1例患者总量大于30 Gy。9例患者化疗采用经肝动脉灌注（HAI）5-氟尿嘧啶，5例采用静脉注射顺铂，3例采用HAI阿霉素。6例（12%）患者出现客观肿瘤消退（完全缓解+部分缓解）。另外10例（20%）患者肿瘤消退超过25%但小于50%，10例（20%）患者疼痛完全或部分缓解。完全缓解和部分缓解的中位持续时间为26周。（摘要截选至400字）
