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热疗联合化疗用于晚期胰腺癌患者的化疗:一项多中心回顾性观察比较研究。

Hyperthermia combined with chemotherapy chemotherapy in patients with advanced pancreatic cancer: A multicenter retrospective observational comparative study.

作者信息

Fiorentini Giammaria, Sarti Donatella, Mambrini Andrea, Hammarberg Ferri Ivano, Bonucci Massimo, Sciacca Paola Giordano, Ballerini Marco, Bonanno Salvatore, Milandri Carlo, Nani Roberto, Guadagni Stefano, Dentico Patrizia, Fiorentini Caterina

机构信息

Integrative Oncology, Integrative Oncology Outpatient Clinic, Bologna 40121, Italy.

Department of Oncology, Santa Maria della Misericordia Hospital, Urbino 60129, Italy.

出版信息

World J Clin Oncol. 2023 Jun 24;14(6):215-226. doi: 10.5306/wjco.v14.i6.215.

DOI:10.5306/wjco.v14.i6.215
PMID:37398545
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10311475/
Abstract

BACKGROUND

Several studies report the useful therapeutic results of regional hyperthermia in association with chemotherapy (CHT) and radiotherapy for the treatment of pancreatic cancer. Modulated electro-hyperthermia (mEHT) is a new hyperthermia technique that induces immunogenic death or apoptosis of pancreatic cancer cells in laboratory experiments and increases tumor response rate and survival in pancreatic cancer patients, offering beneficial therapeutic effects against this severe type of cancer.

AIM

To assess survival, tumor response and toxicity of mEHT alone or combined with CHT compared with CHT for the treatment of locally advanced or metastatic pancreatic cancer.

METHODS

This was a retrospective data collection on patients affected by locally advanced or metastatic pancreatic cancer (stage III and IV) performed in 9 Italian centers, members of International Clinical Hyperthermia Society-Italian Network. This study included 217 patients, 128 (59%) of them were treated with CHT (no-mEHT) and 89 (41%) patients received mEHT alone or in association with CHT. mEHT treatments were performed applying a power of 60-150 watts for 40-90 min, simultaneously or within 72 h of administration of CHT.

RESULTS

Median patients' age was 67 years (range 31-92 years). mEHT group had a median overall survival greater than non-mEHT group (20 mo, range 1.6-24, 9 mo, range 0.4-56.25, < 0.001). mEHT group showed a higher number of partial responses (45% 24%, = 0.0018) and a lower number of progressions (4% 31%, < 0.001) than the no-mEHT group, at the three months follow-up. Adverse events were observed as mild skin burns in 2.6% of mEHT sessions.

CONCLUSION

mEHT seems safe and has beneficial effects on survival and tumor response of stage III-IV pancreatic tumor treatment. Further randomized studies are warranted to confirm or not these results.

摘要

背景

多项研究报告了区域热疗联合化疗(CHT)和放疗治疗胰腺癌的有效治疗效果。调制式电超热疗法(mEHT)是一种新的热疗技术,在实验室实验中可诱导胰腺癌细胞发生免疫原性死亡或凋亡,并提高胰腺癌患者的肿瘤反应率和生存率,对这种严重类型的癌症具有有益的治疗效果。

目的

评估单独使用mEHT或联合CHT与单纯CHT相比,治疗局部晚期或转移性胰腺癌的生存率、肿瘤反应和毒性。

方法

这是一项在9个意大利中心进行的回顾性数据收集研究,这些中心均为国际临床热疗学会意大利网络的成员,研究对象为局部晚期或转移性胰腺癌(III期和IV期)患者。本研究共纳入217例患者,其中128例(59%)接受CHT治疗(未接受mEHT),89例(41%)患者单独接受mEHT治疗或联合CHT治疗。mEHT治疗时施加的功率为60 - 150瓦,持续40 - 90分钟,在CHT给药的同时或72小时内进行。

结果

患者的中位年龄为67岁(范围31 - 92岁)。mEHT组的中位总生存期长于未接受mEHT组(20个月,范围1.6 - 24个月;9个月,范围0.4 - 56.25个月;P < 0.001)。在三个月的随访中,mEHT组的部分缓解例数多于未接受mEHT组(45%对24%,P = 0.0018),进展例数少于未接受mEHT组(4%对31%,P < 0.001)。在2.6%的mEHT治疗疗程中观察到不良事件为轻度皮肤烧伤。

结论

mEHT似乎安全,对III - IV期胰腺肿瘤治疗的生存率和肿瘤反应具有有益影响。需要进一步的随机研究来证实或否定这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/421e/10311475/a0db0454ac52/WJCO-14-215-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/421e/10311475/779c86073ae3/WJCO-14-215-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/421e/10311475/fa7bd325d565/WJCO-14-215-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/421e/10311475/a0db0454ac52/WJCO-14-215-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/421e/10311475/779c86073ae3/WJCO-14-215-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/421e/10311475/fa7bd325d565/WJCO-14-215-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/421e/10311475/a0db0454ac52/WJCO-14-215-g003.jpg

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Immune checkpoint HLA-E:CD94-NKG2A mediates evasion of circulating tumor cells from NK cell surveillance.免疫检查点 HLA-E:CD94-NKG2A 介导循环肿瘤细胞逃避 NK 细胞监视。
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