Lee C K, Song C W, Rhee J G, Levitt S H
Department of Therapeutic Radiology-Radiation Oncology, University of Minnesota Health Sciences Center, Minneapolis.
Radiol Clin North Am. 1989 May;27(3):543-58.
We conducted a phase I clinical trial of the feasibility of using the Thermotron RF-8, a capacitative heating device utilizing 8-MHz RF, for the treatment of deep-seated and bulky human tumors. Preclinical studies with agar phantoms demonstrated that deep heating can be achieved with this device when the electrode diameters are sufficiently large relative to the thickness of the heated object. In the clinical application of capacitive heating with radiofrequency, excessive heating of subcutaneous tissue has often been a problem. However, this could be minimized by continuous cooling of the subcutaneous fat with a 10 degrees C saline bolus, beginning more than 20 minutes prior to the start of heating. It was often possible to raise the temperature of deep-seated tumors even in obese patients by applying this pre-cooling method. The mean achieved temperature during 30 to 40 minutes of heating was higher than 42 degrees C and 40 degrees C to 42 degrees C in 26% and 50% of 58 tumors treated, respectively. A combination of hyperthermia (four to ten sessions, twice a week) with full-course or a limited dose of radiotherapy resulted in complete tumor remission in 7% of patients, and partial tumor remission in 50% of patients. In the full-course radiotherapy group, 69% of the tumors were judged to show complete or partial regression, and in the low-dose group, 43% of the tumors regressed completely or partially. Histologic examination of many of the tumors that did not regress showed massive necrosis, indicating that tumor size after hyperthermia is not an accurate criterion of the treatment result. Side effects were minimal, and vital sign changes during heating were insignificant. Our data, together with those reported by Japanese investigators, clearly demonstrated that hyperthermia with the Thermotron RF-8 in combination with radiotherapy is useful in treating deep-seated and bulky tumors that fail to respond to conventional treatment modalities.
我们开展了一项I期临床试验,以探究使用Thermotron RF - 8(一种利用8兆赫兹射频的电容式加热设备)治疗人体深部和体积较大肿瘤的可行性。对琼脂模型进行的临床前研究表明,当电极直径相对于被加热物体的厚度足够大时,该设备能够实现深部加热。在射频电容式加热的临床应用中,皮下组织过度受热一直是个问题。然而,通过在加热开始前20多分钟开始用10摄氏度的生理盐水团注持续冷却皮下脂肪,这一问题可得到最小化。即使是肥胖患者,采用这种预冷却方法也常常能够提高深部肿瘤的温度。在接受治疗的58个肿瘤中,分别有26%和50%的肿瘤在加热30至40分钟期间达到的平均温度高于42摄氏度和40至42摄氏度。热疗(每周两次,共四至十次)与全疗程或有限剂量放疗相结合,使7%的患者肿瘤完全缓解,50%的患者肿瘤部分缓解。在全疗程放疗组中,69%的肿瘤被判定完全或部分消退,在低剂量组中,43%的肿瘤完全或部分消退。对许多未消退的肿瘤进行组织学检查发现有大量坏死,这表明热疗后肿瘤大小并非治疗效果的准确标准。副作用极小,加热期间生命体征变化不显著。我们的数据以及日本研究人员报告的数据清楚地表明,使用Thermotron RF - 8进行热疗并结合放疗,对于治疗对传统治疗方式无反应的深部和体积较大肿瘤是有效的。