McChesney Gillette S, Dawson C A, Scott R J, Rickaby D A, Powers B E, Johnston M R, Chen C, Gillette E L
Department of Radiological Health Sciences, Colorado State University, Fort Collins 80523.
Int J Hyperthermia. 1993 May-Jun;9(3):369-82. doi: 10.3109/02656739309005037.
Whole-body hyperthermia has potential as an adjuvant treatment with chemotherapy and radiation therapy for diseases such as lung cancer which require both local and systemic control. The acute toxicity of whole-body hyperthermia combined with whole-thorax irradiation was studied in dogs. Twenty-eight dogs received three 2-h whole-body hyperthermia (WBH) treatments at 42.0 degrees C deep rectal temperature. Twenty-four of these dogs were also randomized to receive radiation doses of 18, 22.5, 27, 31.5, 40.5 or 45 Gy. Irradiation was given in 1.5 Gy fractions over 6 weeks. Three WBH treatments were given to 28 dogs with all dogs surviving treatment. WBH was given on days 1, 22 and 40 of the 6-week interval. Thirty-one dogs received radiation doses of 18-49.5 Gy without WBH. Deep rectal temperature was maintained at 41.9 +/- 0.3 degrees C over 2 h with an average of 20 min outside the chamber for irradiation. Two dogs required intervention with emergency medications during WBH treatment. One of the two dogs developed permanent neurological injury. Continuous physiological monitoring was necessary for successful WBH. WBH plus thoracic irradiation was well tolerated. All dogs survived all treatments. A significant but transient increase in peripheral blood leucocytes and a decrease in platelet counts occurred after each WBH treatment. The addition of thoracic irradiation up to 45 Gy in 1.5 Gy fractions did not appear to alter the acute toxicity of WBH with the exception of an increase in the protein content of lung lavage fluids. In conclusion, multiple WBH treatments of 2 h at a target temperature of 42 degrees C in addition to thoracic irradiation up to 45 Gy in 1.5 Gy fractions was administered with only mild acute toxicities occurring. Core temperature could be maintained for up to 20 min outside of the WBH chamber which allowed irradiation to be given concurrently with hyperthermia at a core temperature of 42 degrees C +/- 0.1 degree C.
全身热疗作为一种辅助治疗手段，与化疗和放疗联合应用于肺癌等需要局部和全身控制的疾病具有潜在价值。研究了全身热疗联合全胸照射在犬类中的急性毒性。28只犬在直肠深部温度为42.0℃的情况下接受了三次每次2小时的全身热疗（WBH）治疗。其中24只犬还被随机分配接受18、22.5、27、31.5、40.5或45 Gy的放射剂量。放射治疗分6周进行，每次1.5 Gy。28只犬接受了三次WBH治疗，所有犬均存活。WBH在6周间隔的第1天、第22天和第40天进行。31只犬接受了18 - 49.5 Gy的放射剂量但未进行WBH。在2小时内将直肠深部温度维持在41.9±0.3℃，平均每次有20分钟在治疗室外接受照射。两只犬在WBH治疗期间需要使用急救药物进行干预。两只犬中有一只出现了永久性神经损伤。成功进行WBH需要持续的生理监测。WBH加胸部照射耐受性良好。所有犬均存活了所有治疗。每次WBH治疗后外周血白细胞显著但短暂升高，血小板计数下降。除了肺灌洗液蛋白质含量增加外，分1.5 Gy剂量给予高达45 Gy的胸部照射似乎并未改变WBH的急性毒性。总之，除了分1.5 Gy剂量给予高达45 Gy的胸部照射外，在目标温度42℃下进行多次2小时的WBH治疗，仅出现轻度急性毒性。在WBH治疗室外核心温度可维持长达20分钟，这使得在核心温度为42℃±0.1℃时可同时进行热疗和照射。
