Yoshikawa Nobuhisa, Itoh Yoshiyuki, Matsukawa Tetsuya, Kawamura Mariko, Yamada Keiichiro, Nakamura Seiji, Kajiyama Hiroaki
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Radiology, Anjo Kosei Hospital, Anjo, Japan.
Nagoya J Med Sci. 2023 Aug;85(3):639-647. doi: 10.18999/nagjms.85.3.639.
We evaluated the efficacy and safety of an endoscope-embedded transvaginal laser hyperthermia system for superficial cervical cancer that remained in the cervix after radiotherapy. We developed an innovative endoscope-embedded hyperthermia system consisting of a diode laser device, a temperature control unit, an endoscope control unit, and a transvaginal probe. Superficial lesions of recurrent or residual cervical cancer on the uterine cervix or vaginal wall after radiotherapy were eligible for this study. A total of four cases of three patients were eligible for this treatment. Case 1: The post-chemoradiotherapy residual tumor of a patient with stage IIB squamous cell carcinoma of the cervix was treated with the device. Two months after the laser hyperthermia treatment, the tumor's disappearance was confirmed. Case 2: A post-hysterectomy persistent tumor on the vaginal stump of a patient with stage IIB adenocarcinoma of the cervix was subjected to the laser hyperthermia treatment. Two months after the treatment, the stump's cytology was false positive. Case 3: As in case 2, this patient's recurrence in the anterior vaginal wall was subjected to laser hyperthermia treatment, but the tumor's growth was not controlled. Case 4: A tumor at the vaginal margin was identified during a salvage hysterectomy in a patient with stage IIB squamous cell carcinoma of the cervix who underwent chemoradiotherapy. After laser hyperthermia treatment, the tumor's disappearance was confirmed. Our new endoscope-embedded laser hyperthermia system can be a candidate for treating residual superficial cervical cancer after radiotherapy by accurately capturing superficial lesions.
我们评估了一种用于治疗放疗后仍残留在宫颈的浅表宫颈癌的内窥镜嵌入式经阴道激光热疗系统的疗效和安全性。我们开发了一种创新的内窥镜嵌入式热疗系统,该系统由二极管激光设备、温度控制单元、内窥镜控制单元和经阴道探头组成。放疗后子宫颈或阴道壁上复发性或残留性宫颈癌的浅表病变符合本研究的条件。共有3名患者的4例病例符合该治疗条件。病例1:一名患有IIB期宫颈鳞状细胞癌的患者在放化疗后的残留肿瘤用该设备进行了治疗。激光热疗治疗两个月后,肿瘤消失得到确认。病例2:一名患有IIB期宫颈腺癌的患者在子宫切除术后阴道残端出现持续性肿瘤,接受了激光热疗治疗。治疗两个月后,残端细胞学检查为假阳性。病例3:与病例2一样,该患者阴道前壁复发接受了激光热疗治疗,但肿瘤生长未得到控制。病例4:一名接受放化疗的IIB期宫颈鳞状细胞癌患者在挽救性子宫切除术中发现阴道边缘有肿瘤。激光热疗治疗后,肿瘤消失得到确认。我们新的内窥镜嵌入式激光热疗系统通过准确捕获浅表病变,可成为治疗放疗后残留浅表宫颈癌的一种选择。