Yonemura Y, Fujimura T, Takegawa S, Kamata T, Fushida S, Urade M, Miwa K, Miyazaki I, Nakajima K, Hisazumi H
Dept. of Surgery II, School of Medicine, Kanazawa University.
Gan To Kagaku Ryoho. 1987 Oct;14(10):2890-4.
We carried out a combination preoperative therapy involving radiofrequency hyperthermia (8 MHz or 13.56 MHz) with radiation (10-MV X-ray) or chemotherapy (Mitomycin C, CDDP or UFT) for 24 advanced gastric cancers with the aim of preventing local recurrence and improving resectability. The tumor and histological effects were evaluated in each case. Furthermore, an agar phantom possessing a cavity, for simulating the stomach, was employed in an experiment to evaluate temperature distribution upon RF-heating. In the experiment using the agar phantom, the rising temperature around the cavity at 3 o'clock was higher than at 5' and 6 o'clock. This suggested that gastric juice and air must be aspirated when treating a patient by RF-heating. Of the 24 tumors, 4 (17%) showed partial response. Histological effects were observed in 67% of 21 primary tumors. The rate of histological effects in metastases of lymph nodes, liver and peritoneum were 29% (4/14), 100% (2/2) and 0% (0/4), respectively. Tumor response was closely correlated with irradiation and the temperature in the stomach cavity (over 42.5 degrees C). Almost all patients showed good tolerance of this combined therapy. These results show that combined treatment involving radiation, chemotherapy and hyperthermia appears to be a potentially useful from of preoperative therapy for patients with advanced gastric cancer.
我们对24例进展期胃癌实施了术前联合治疗，包括射频热疗（8兆赫或13.56兆赫）与放疗（10兆伏X射线）或化疗（丝裂霉素C、顺铂或优福定），目的是预防局部复发并提高可切除性。对每例患者的肿瘤及组织学效果进行了评估。此外，在一项实验中使用了一个带有模拟胃腔的琼脂模型，以评估射频加热时的温度分布。在使用琼脂模型的实验中，胃腔3点钟位置周围的升温高于5点钟和6点钟位置。这表明在对患者进行射频加热治疗时必须抽吸胃液和空气。24例肿瘤中，4例（17%）显示部分缓解。21例原发性肿瘤中有67%观察到组织学效果。淋巴结转移、肝转移和腹膜转移的组织学效果发生率分别为29%（4/14）、100%（2/2）和0%（0/4）。肿瘤反应与照射及胃腔内温度（超过42.5摄氏度）密切相关。几乎所有患者对这种联合治疗耐受性良好。这些结果表明，放疗、化疗和热疗相结合的治疗方法似乎是进展期胃癌患者术前治疗的一种潜在有效方式。
