Hiraoka M, Jo S, Akuta K, Nishimura Y, Takahashi M, Abe M
Cancer. 1987 Jul 1;60(1):128-35. doi: 10.1002/1097-0142(19870701)60:1<128::aid-cncr2820600124>3.0.co;2-v.
Clinical effects and safety of radiofrequency (RF) capacitive hyperthermia in combination with radiotherapy were evaluated in 40 patients with locally advanced deep-seated tumors. Hyperthermia was administered regionally with an 8-MHz or a 13.56-MHz RF heating device, once or twice a week after irradiation, four to 13 sessions total. Radiotherapy was delivered in fractions of 170 to 200 cGy a day, 5 days a week to 30 to 70 Gy to 33 patients, whereas the remaining seven patients received a total dose of 28 to 60 Gy in fractions of 400 cGy, twice a week. Six of the 40 tumors treated showed CR (100% regression), 6 PRa (80%-100% regression), 13 PRb (50%-80% regression), and 15 NR (less than 50% regression) when assessed by tumor size on computerized tomography (CT) scan. The tumor size before treatment was significantly smaller in CR + PRa tumors than in PRb + NR ones. TDF Time-dose fractionation (TDF) and number of heat treatments, however, did not differ significantly between the both tumors. Greater regression was observed in tumors heated to 41 to 43 degrees C in the maximum temperature than in tumors heated to below 41 degrees C or above 43 degrees C. The minimum tumor temperature was not related to the tumor regression. Posttreatment CT scan revealed remarkable low-density areas in 18 of the 34 tumors that did not regress completely. Histopathologic examinations demonstrated the low-density area to be massive coagulation necrosis and no malignant cell was observed in two tumors examined thoroughly. The types of low-density areas, which were classified according to its percent area in the tumor, correlated with the maximum and minimum tumor temperature. Most of the type III tumors (more than 80% low density) did not regrow in follow-up studies. Complications consisted of subcutaneous fat necrosis in four patients, local edema in four patients, and one abdominal abscess in one patient, all of which eventually resolved. These clinical results strongly suggest the usefulness of RF capacitive hyperthermia combined with radiotherapy for the treatment of refractory deep-seated tumors, and that intratumor low-density areas which appear on posttreatment CT seems to be a good parameter for assessing the tumor response to thermoradiotherapy.
对40例局部晚期深部肿瘤患者评估了射频（RF）电容性热疗联合放疗的临床疗效和安全性。使用8MHz或13.56MHz的射频加热设备进行局部热疗，放疗后每周1次或2次，共进行4至13次。33例患者每天分170至200cGy进行放疗，每周5天，总量达30至70Gy；其余7例患者每周2次，每次400cGy，总量达28至60Gy。根据计算机断层扫描（CT）上的肿瘤大小评估，40例接受治疗的肿瘤中，6例显示完全缓解（CR，100%消退），6例部分缓解a（PRa，80%-100%消退），13例部分缓解b（PRb，50%-80%消退），15例无反应（NR，小于50%消退）。CR+PRa组肿瘤治疗前的大小明显小于PRb+NR组。然而，两组肿瘤的时间剂量分割（TDF）和热疗次数并无显著差异。与加热至低于41℃或高于43℃的肿瘤相比，加热至最高温度41至43℃的肿瘤消退更明显。最低肿瘤温度与肿瘤消退无关。治疗后CT扫描显示，34例未完全消退的肿瘤中有18例出现明显的低密度区。组织病理学检查显示，低密度区为大片凝固性坏死，在彻底检查的2例肿瘤中未观察到恶性细胞。根据肿瘤中低密度区的面积百分比分类的低密度区类型，与最高和最低肿瘤温度相关。在随访研究中，大多数III型肿瘤（低密度区超过80%）未复发。并发症包括4例患者出现皮下脂肪坏死，4例患者出现局部水肿，1例患者出现腹部脓肿，所有这些最终均得到缓解。这些临床结果有力地表明，RF电容性热疗联合放疗对难治性深部肿瘤的治疗有用，且治疗后CT上出现的瘤内低密度区似乎是评估肿瘤对热放疗反应的良好指标。
