Thrall D E, Prescott D M, Samulski T V, Rosner G L, Denman D L, Legorreta R L, Dodge R K, Page R L, Cline J M, Lee J, Case B C, Evans S M, Oleson J R, Dewhirst M W
College of Veterinary Medicine, North Carolina State University, Raleigh, USA.
Int J Radiat Oncol Biol Phys. 1996 Mar 15;34(5):1087-96. doi: 10.1016/0360-3016(95)02260-0.
The purpose of this study was to assess the effect of increasing intratumoral temperatures by the combination of local hyperthermia (LH) and whole body hyperthermia (WBH) on the radiation response of canine sarcomas.
Dogs with spontaneous soft tissue sarcomas and no evidence of metastasis were randomized to be treated with radiation combined with either LH alone or LH + WBH. Dogs were accessioned for treatment at two institutions. The radiation dose was 56.25 Gy, given in 25 2.25 Gy daily fractions. Two hyperthermia treatments were given; one during the first and one during the last week of treatment. Dogs were evaluated after treatment for local recurrence, metastasis, and complications.
Sixty-four dogs were treated between 1989 and 1993. The use of LH+WBH resulted in statistically significant increases in the low and middle regions of the temperature distributions. The largest increase was in the low temperatures with median CEM 43 T90 values of 4 vs. 49 min for LH vs. LH + WBH, respectively (p<0.001). There was no difference in duration of local tumor control between hyperthermia groups (p = 0.59). The time to metastasis was shorter for dogs receiving LH + WBH (p = 0.02); the hazard ratio for metastatic disease for dogs in the LH + WBH group was 2.4 (95% confidence interval, 1.2-5.4) with respect to dogs in the LH group. Complications were greater in larger tumors and in tumors treated with LH + WBH, CONCLUSION: The combination of LH + WBH with radiation therapy, as described herein, was not associated with an increase in local tumor control in comparison to use of LH with radiation therapy. The combination of LH + WBH also appeared to alter the biology of the metastatic process and was associated with more complications than LH. We identified no rationale for further study of LH + WBH in combination with radiation for treatment of solid tumors.
本研究旨在评估局部热疗（LH）与全身热疗（WBH）联合应用提高肿瘤内温度对犬肉瘤放射反应的影响。
患有自发性软组织肉瘤且无转移证据的犬被随机分为接受单纯放射联合LH或LH + WBH治疗。在两个机构纳入犬进行治疗。放射剂量为56.25 Gy，分25次给予，每次2.25 Gy，每日一次。进行两次热疗；一次在治疗的第一周，一次在治疗的最后一周。治疗后对犬进行局部复发、转移和并发症评估。
1989年至1993年期间共治疗64只犬。LH + WBH的应用导致温度分布的低、中部区域有统计学意义的升高。最大的升高出现在低温区域，LH组与LH + WBH组的中位CEM 43 T90值分别为4分钟和49分钟（p < 0.001）。热疗组之间局部肿瘤控制持续时间无差异（p = 0.59）。接受LH + WBH治疗的犬发生转移的时间较短（p = 0.02）；LH + WBH组犬发生转移性疾病的风险比相对于LH组犬为2.4（95%置信区间，1.2 - 5.4）。较大肿瘤以及接受LH + WBH治疗的肿瘤并发症更多。
本文所述的LH + WBH与放射治疗联合应用与单纯LH与放射治疗相比，并未增加局部肿瘤控制率。LH + WBH联合应用似乎也改变了转移过程的生物学特性，且与比LH更多的并发症相关。我们未发现有理由进一步研究LH + WBH与放射联合用于实体瘤治疗。
