Obata Shiro, Ishimaru Yutaka, Miyagi Shigenori, Nakatake Mika, Kuroiwa Akira, Ohta Yoshiaki, Kan Tsunehiko, Kanegae Shinya, Inoue Yohta, Nishizato Rhoichi, Miyazaki Kohki
Department of Radiology and Radiotherapy, Nagasaki Prefecture Shimabara Hospital, Shimabara, Nagasaki 855-0861, Japan.
Mol Clin Oncol. 2022 Mar;16(3):68. doi: 10.3892/mco.2022.2501. Epub 2022 Jan 21.
Kochi oxydol radiation therapy for unresectable carcinomas (KORTUC) is a novel cancer treatment method developed in Japan. KORTUC targets resistance factors in cancer therapy, such as low-oxygen environments and excessive antioxidant enzymes. This may enhance the effects of conventional treatments. The present study reports the experience of the Nagasaki Prefecture Shimabara Hospital in using KORTUC treatment for a series of 210 patients between January 2010 and June 2019. When this radiosensitizer, a mixture of a dilute hydrogen peroxide solution (0.5 ml, 3%/unit) and sodium hyaluronate (2.5 ml, 0.83%/unit), is administered and applied directly to the cancer lesion, antioxidant enzymes are neutralized and degraded causing reoxygenation as a secondary by-product, thereby enhancing the cytotoxic effect of radiation. The radiosensitizer was administered twice per week before irradiation. Up to June 2019, KORTUC was administered to 210 patients. The most common disease stage was stage IV in 137 patients (65%), followed by stage III in 25 patients, stage I in 17 patients and stage II in 7 patients (unknown disease stage in 24 patients). Of the 186 patients who could be followed up after the treatment, 28 (15%) patients had a complete response (Response Evaluation Criteria in Solid Tumors version 1.1), 59 (32%) had a partial response, 73 (39%) had stable disease and 26 (14%) had progressive disease. No significant treatment-related adverse events were observed. The present study highlights the reports of 4 cases (3 cases from among the 28 patients with complete responses): i) A case of advanced, inoperable breast cancer; ii) a refractory patient with recurrence a decade after postoperative irradiation; iii) a patient with advanced, inoperable rectal cancer; and iv) a patient with lymph node metastases. Overall, KORTUC showed good efficacy and tolerable safety for various types of radioresistant tumors, and it has the potential for immediate worldwide use.
高知氧代尔放射疗法治疗不可切除癌（KORTUC）是日本研发的一种新型癌症治疗方法。KORTUC针对癌症治疗中的耐药因素，如低氧环境和过量的抗氧化酶。这可能会增强传统治疗的效果。本研究报告了长崎县岛原医院在2010年1月至2019年6月期间对210例患者使用KORTUC治疗的经验。当这种放射增敏剂（一种稀过氧化氢溶液（0.5毫升，3%/单位）和透明质酸钠（2.5毫升，0.83%/单位）的混合物）给药并直接应用于癌灶时，抗氧化酶被中和并降解，作为次要副产物导致再氧合，从而增强辐射的细胞毒性作用。放射增敏剂在放疗前每周给药两次。截至2019年6月，210例患者接受了KORTUC治疗。最常见的疾病分期为IV期，共137例（65%），其次是III期25例、I期17例和II期7例（24例患者疾病分期不明）。在治疗后可进行随访的186例患者中，28例（15%）患者达到完全缓解（实体瘤疗效评价标准1.1版），59例（32%）部分缓解，73例（39%）病情稳定，26例（14%）病情进展。未观察到明显的与治疗相关的不良事件。本研究重点介绍了4例病例（28例完全缓解患者中的3例）：i）1例晚期不可手术乳腺癌；ii）1例术后放疗十年后复发的难治性患者；iii）1例晚期不可手术直肠癌患者；iv）1例有淋巴结转移的患者。总体而言，KORTUC对各种类型的放射抗性肿瘤显示出良好的疗效和可耐受的安全性，并且有立即在全球范围内应用的潜力。
