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用于脑肿瘤的微波热疗

Microwave hyperthermia for brain tumors.

作者信息

Winter A, Laing J, Paglione R, Sterzer F

出版信息

Neurosurgery. 1985 Sep;17(3):387-99. doi: 10.1227/00006123-198509000-00001.

Abstract

Twelve patients with malignant brain tumors who had failed to respond to conventional therapies were treated with thermotherapy. Hyperthermic temperatures (approximately 43 degrees C) were induced in the tumors using microwaves at a frequency of 2450 MHz that were guided into the tumors by one or more semirigid coaxial applicators. These applicators fit into 16 gauge tubes or needles and can be inserted into the brain with minimal damage to healthy tissues. During each treatment, the tumors were maintained at hyperthermic temperatures for 1 hour. Several treatments spaced a few days apart were usually administered. The procedure used for producing hyperthermia in brain tumors with microwaves proved to be safe and could be repeated several times without producing toxic effects. Objective tumor responses were obtained in 75% of the patients (decrease in tumor size, 3 patients; slowing of tumor growth, 2 patients; necrosis of tumor tissues verified by pathological examination, 4 patients). Favorable clinical responses were observed in 75% of the patients (rapid decrease in intractable headaches, 5 patients; improvements in clinical deficits, 4 patients). Also, in all patients, the microwave power required to heat for a given time or a given volume decreased during most of the thermotherapy sessions, possibly because of heat damage to the tumor vasculature. Our results, taken together with the results of other investigators, indicate that thermotherapy is a promising modality for treating malignant brain tumors, either as the sole therapy or in combination with radiotherapy and chemotherapy. The next logical steps would be Phase I/II type trials of subjects whose disease is less advanced than the disease of patients treated in the current series of investigations.

摘要

12例对传统疗法无反应的恶性脑肿瘤患者接受了热疗。使用2450兆赫兹的微波在肿瘤中诱导产生高热温度(约43摄氏度),微波由一个或多个半刚性同轴施源器导入肿瘤。这些施源器可适配16号管或针,并能以对健康组织损伤最小的方式插入大脑。每次治疗期间,肿瘤在高热温度下维持1小时。通常进行几次间隔几天的治疗。用微波在脑肿瘤中产生高热的方法被证明是安全的,并且可以重复几次而不产生毒性作用。75%的患者获得了客观的肿瘤反应(肿瘤大小减小,3例;肿瘤生长减缓,2例;经病理检查证实肿瘤组织坏死,4例)。75%的患者观察到良好的临床反应(顽固性头痛迅速减轻,5例;临床缺陷改善,4例)。此外,在所有患者中,在大多数热疗疗程中,加热给定时间或给定体积所需的微波功率下降,这可能是由于肿瘤血管受到热损伤。我们的结果与其他研究者的结果一起表明,热疗无论是作为单一疗法还是与放疗和化疗联合使用,都是治疗恶性脑肿瘤的一种有前景的方法。接下来合理的步骤将是对疾病程度不如当前系列研究中所治疗患者严重的受试者进行I/II期试验。

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