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系统评价补充医学热疗在肿瘤学中的应用。

Systematic review about complementary medical hyperthermia in oncology.

机构信息

Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.

Klinik und Poliklinik für Strahlentherapie, LMU Klinikum, Munich, Germany.

出版信息

Clin Exp Med. 2022 Nov;22(4):519-565. doi: 10.1007/s10238-022-00846-9. Epub 2022 Jun 29.

Abstract

Hyperthermia is a generic term for different techniques using heat in cancer therapies. Temperatures of about 42° Celsius in combination with chemo- or radiotherapy may improve the effectiveness of those treatments. Clinical benefit is shown in "standard hyperthermia" with tumour temperatures assessed during treatment. This systematic review thoroughly assesses the state of evidence concerning the benefits and side effects of electro hyperthermia or whole-body hyperthermia ("alternative hyperthermia") in oncology. From 26 April 2021 to 09 May 2021, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsycINFO, CINAHL and Medline) to find studies concerning the use, effectiveness and potential harm of alternative medical hyperthermia therapy on cancer patients. From all 47,388 search results, 53 publications concerning 53 studies with 2006 patients were included in this systematic review. The patients were diagnosed with different types of cancer. The hyperthermic methods included whole-body hyperthermia (WBH) with different methods and electro hyperthermia (EH). The majority of the included studies were single-arm studies, counting in total 32 studies. Six studies were randomized controlled trials (RCT). In addition, one systematic review (SR) was found. The most critical endpoints were tumour response, survival data, pain relief, myelosuppression and toxicities. Outcome was heterogeneous, and considering the methodological limitations, clinical evidence for the benefit of alternative hyperthermia in cancer patients is lacking. Neither for whole-body hyperthermia nor for electro hyperthermia there is any evidence with respect to improvement of survival or quality of life in cancer patients.

摘要

高热疗法是癌症治疗中使用热的不同技术的统称。约 42°C 的温度与化疗或放疗联合使用可能会提高这些治疗方法的效果。在治疗期间评估肿瘤温度的“标准高热疗法”中显示出了临床益处。本系统评价全面评估了电高热疗法或全身高热疗法(“替代高热疗法”)在肿瘤学中的益处和副作用的证据状况。从 2021 年 4 月 26 日至 2021 年 5 月 9 日,系统地检索了五个电子数据库(Embase、Cochrane、PsycINFO、CINAHL 和 Medline),以查找关于替代医学高热疗法在癌症患者中的使用、效果和潜在危害的研究。从所有 47388 个检索结果中,纳入了 53 篇文献,涉及 53 项研究,共 2006 例患者。这些患者被诊断患有不同类型的癌症。高热方法包括全身高热疗法(WBH)和电高热疗法(EH)。纳入的大多数研究为单臂研究,共计 32 项研究。6 项研究为随机对照试验(RCT)。此外,还发现了 1 项系统评价(SR)。最关键的终点是肿瘤反应、生存数据、疼痛缓解、骨髓抑制和毒性。结果存在异质性,考虑到方法学的局限性,缺乏替代高热疗法对癌症患者有益的临床证据。无论是全身高热疗法还是电高热疗法,都没有证据表明能改善癌症患者的生存或生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0720/9588476/a5a256d3c0c8/10238_2022_846_Fig1_HTML.jpg

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