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一项关于在欧洲临床中心联合应用热疗与放(化)疗或化疗的治疗模式分析。

A patterns of care analysis of hyperthermia in combination with radio(chemo)therapy or chemotherapy in European clinical centers.

机构信息

Centre for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, Switzerland.

Doctoral Clinical Science Program, Medical Faculty, University of Zurich, Zurich, Switzerland.

出版信息

Strahlenther Onkol. 2023 May;199(5):436-444. doi: 10.1007/s00066-022-01980-9. Epub 2022 Aug 29.

Abstract

PURPOSE

The combination of hyperthermia (HT) with radio(chemo)therapy or chemotherapy (CT) is an established treatment strategy for specific indications. Its application in routine clinical practice in Europe depends on regulatory and local conditions. We conducted a survey among European clinical centers to determine current practice of HT.

METHODS

A questionnaire with 22 questions was sent to 24 European HT centers. The questions were divided into two main categories. The first category assessed how many patients are treated with HT in combination with radio(chemo)therapy or CT for specific indications per year. The second category addressed which hyperthermia parameters are recorded. Analysis was performed using descriptive methods.

RESULTS

The response rate was 71% (17/24) and 16 centers were included in this evaluation. Annually, these 16 centers treat approximately 637 patients using HT in combination with radio(chemo)therapy or CT. On average, 34% (range: 3-100%) of patients are treated in clinical study protocols. Temperature readings and the time interval between HT and radio(chemo)therapy or CT are recorded in 13 (81%) and 9 (56%) centers, respectively. The thermal dose quality parameter "cumulative equivalent minutes at 43 °C" (CEM43°C) is only evaluated in five (31%) centers for each HT session. With regard to treatment sequence, 8 (50%) centers administer HT before radio(chemo)therapy and the other 8 in the reverse order.

CONCLUSION

There is a significant heterogeneity among European HT centers as to the indications treated and the recording of thermometric parameters. More evidence from clinical studies is necessary to achieve standardization of HT practice.

摘要

目的

热疗(HT)联合放化疗或化疗(CT)是特定适应证的既定治疗策略。其在欧洲常规临床实践中的应用取决于监管和当地条件。我们对欧洲临床中心进行了一项调查,以确定 HT 的当前实践情况。

方法

向 24 个欧洲 HT 中心发送了一份包含 22 个问题的问卷。这些问题分为两个主要类别。第一类评估了每年有多少患者因特定适应证接受 HT 联合放化疗或 CT 治疗。第二类涉及记录哪些热疗参数。分析采用描述性方法。

结果

回复率为 71%(17/24),有 16 个中心参与了此项评估。这 16 个中心每年大约有 637 例患者接受 HT 联合放化疗或 CT 治疗。平均而言,34%(范围:3-100%)的患者在临床研究方案中接受治疗。在 13 个(81%)中心记录了温度读数,在 9 个(56%)中心记录了 HT 与放化疗或 CT 之间的时间间隔。每个 HT 疗程仅在 5 个(31%)中心评估热剂量质量参数“43°C 累积等效分钟”(CEM43°C)。在治疗顺序方面,8 个(50%)中心先进行 HT,然后再进行放化疗,而另外 8 个中心则相反。

结论

欧洲 HT 中心在治疗适应证和记录测温参数方面存在显著异质性。需要更多来自临床研究的证据来实现 HT 实践的标准化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd0/10133066/82ae361e6125/66_2022_1980_Fig1_HTML.jpg

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