Perez C A, Patterson J H, Emami B
Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri 63108.
Am J Clin Oncol. 1993 Dec;16(6):469-76. doi: 10.1097/00000421-199312000-00002.
This report describes biologic experiments using transplanted RIF-1 tumors (diameter 0.5 or 1 cm) in C3H/He inbred mice (12 to 20 per treatment group) to compare the results with heat alone (43 degrees C for 60 minutes or 45 degrees C for 15 minutes, twice weekly via radiofrequency electrodes), irradiation alone (400 cGy twice weekly for a total of 4,000 cGy with 140 kVp x-rays), or a combination of both therapies. Animals receiving combined treatment had significantly greater complete regression than those treated with either therapy alone. Tumor regrowth curves were equivalent for 43 degrees C or 45 degrees C following irradiation. In tumors 0.5 cm in diameter the overall tumor cure rates were 17% for 43 degrees C for 60 minutes and 25% for 45 degrees C for 15 minutes with heat alone and 8% with irradiation alone; the combination of irradiation and heat at both temperatures yielded comparable complete cure rates (75 and 67%). With 1-cm tumors the corresponding cure rates were 0% with heat alone (either temperature), 5% for irradiation alone, 33% for irradiation and 43 degrees C heat, and 64% for irradiation and 45 degrees C heat (p = .3). Approximately 20% of the animals in the various groups developed moist or dry desquamation in the area treated, whereas 40 to 66% exhibited moist desquamation. There was a slight increase in this sequela (73%) for mice that received irradiation and 45 degrees C compared with 50% in mice treated with 43 degrees C, but the difference was not statistically different (p = .54). Experimental studies demonstrated equivalent efficacy of 10 hyperthermia sessions at 43 degrees C or 45 degrees C combined with irradiation. Caution must be exercised in the clinical application of thermal iso-effect heat dose concepts until further clinical trials have been performed and there is a better understanding of the time-temperature relationship.
本报告描述了在C3H/He近交系小鼠(每个治疗组12至20只)中使用移植的RIF-1肿瘤(直径0.5或1厘米)进行的生物学实验,以将结果与单独加热(43℃持续60分钟或45℃持续15分钟,每周两次通过射频电极)、单独照射(每周两次400 cGy,总共4000 cGy,使用140 kVp X射线)或两种疗法联合使用进行比较。接受联合治疗的动物比单独接受任何一种疗法的动物有显著更高的完全消退率。照射后,43℃或45℃的肿瘤再生长曲线相当。在直径0.5厘米的肿瘤中,单独加热时,43℃持续60分钟的总体肿瘤治愈率为17%,45℃持续15分钟的为25%,单独照射的为8%;在这两个温度下,照射与加热联合使用产生了相当的完全治愈率(75%和67%)。对于1厘米的肿瘤,单独加热(任何一个温度)的相应治愈率为0%,单独照射为5%,照射加43℃加热为33%,照射加45℃加热为64%(p = 0.3)。各治疗组中约20%的动物在治疗区域出现湿性或干性脱屑,而40%至66%表现为湿性脱屑。与接受43℃治疗的小鼠中50%相比,接受照射加45℃治疗的小鼠中这种后遗症略有增加(73%),但差异无统计学意义(p = 0.54)。实验研究表明在43℃或45℃下进行10次热疗联合照射具有同等疗效。在进行进一步的临床试验并更好地理解时间-温度关系之前,在热等效热剂量概念的临床应用中必须谨慎。