Croghan M K, Shimm D S, Hynynen K H, Anhalt D P, Valencic S L, Fletcher A M, Kittleson J M, Cetas T C
Department of Radiation Oncology, University of Arizona College of Medicine, Tucson 85724.
Am J Clin Oncol. 1993 Aug;16(4):354-8. doi: 10.1097/00000421-199308000-00017.
This study examines the consequences of allowing moderate systemic hyperthermia during regional heating of the abdomen and pelvis in 29 patients participating in Phase I studies of hyperthermia combined with chemotherapy or radiation therapy. In Group 1 (20 patients, 42 treatments), systemic temperatures were limited by employing surface cooling, while in Group 2 (9 patients, 24 treatments), surface warming and insulation were used so that systemic temperature would rise. Mean time-averaged oral temperatures were 38.4 degrees C and 39.9 degrees C for Groups 1 and 2, respectively. Time-averaged mean regional temperatures were 40.2 +/- 0.7 degrees C and 41.5 +/- 0.2 degrees C for Groups 1 and 2, respectively (p < .001). Regional temperatures > or = 41.0 degrees C were achieved by 64% of Group 1 and all Group 2 patients. The mean time-averaged power required was significantly lower for Group 2 (453 W vs 740 W; p = .032), as was the incidence of pain. Mean maximum pulse rate was significantly higher in Group 2, although this was not associated with symptoms. Allowing systemic temperature to rise decreased power requirements and treatment-related pain, at the cost of an asymptomatic increase in heart rate. The results suggest that regional heating may be more readily achieved in the setting of elevated systemic temperature.
本研究调查了29名参与热疗联合化疗或放疗I期研究的患者在腹部和盆腔区域加热期间允许适度全身热疗的后果。在第1组（20名患者，42次治疗）中，通过表面冷却限制全身温度，而在第2组（9名患者，24次治疗）中，使用表面加热和保温以使全身温度升高。第1组和第2组的平均时间平均口腔温度分别为38.4℃和39.9℃。第1组和第2组的时间平均平均区域温度分别为40.2±0.7℃和41.5±0.2℃（p<0.001）。第1组64%的患者和第2组所有患者的区域温度达到≥41.0℃。第2组所需的平均时间平均功率显著更低（453W对740W；p = 0.032），疼痛发生率也是如此。第2组的平均最大脉搏率显著更高，尽管这与症状无关。允许全身温度升高可降低功率需求和治疗相关疼痛，但代价是心率无症状增加。结果表明，在全身温度升高的情况下，区域加热可能更容易实现。
