摘要
目的探讨立体定向体部放射治疗辅以微波全身热疗在晚期复治肿瘤患者治疗中的临床价值。方法对170例患者依其治疗手段以回顾性研究方式分为放疗组(99例)、热放疗组(37例)及热疗组(34例)。放疗组主要采用60Co r-刀治疗系统及Rapidac直线加速器精确放疗系统实施治疗。总剂量范围35~65 Gy。热疗组采用WB-1型高能聚焦微波热疗机行腹部照射透热方式致患者机体体温升高至39.5℃~41.5℃,持续60~90 min。热放疗组为放射治疗周期期间及先后同步予以全身热疗。结果放疗组及热疗组肿瘤缓解总有效率(ORR)(3.3%及2.9%)低于热放疗组(13.5%)(P<0.05),其中泌尿系统及头颈肿瘤比例略高。热放疗组与热疗组患者平均总生存期(OS)(5.16个月与5.08个月)低于放疗组(6.32个月),但差异未见统计学意义(P>0.05)。单纯放疗组总生存期略高的复治患者中盆腔妇科及肺部肿瘤较高。结论在复治性晚期肿瘤治疗中,立体定位放疗辅以全身热疗可部分提高肿瘤缓解有效率,但生存期并未明显获益。单纯放疗者总平均生存期略高,单项姑息减症性治疗(如放疗)晚期癌症患者可能更有实际临床意义。
Objective To investigate the effects of hyperthermia-therapy adjuvant stereotaxic radiotherapy on patients with re-treating advanced cancer. Methods A total of 170 patients with advanced recurrent cancer were divided into radiotherapy group（ 99 cases）,hyperthermia and radiotherapy group（ 37 cases） and hyperthermia group（ 34 cases） according to the different treatment methods. The patients in the radiotherapy group were treated with the 60 Co r-knife treatment system and the precise radiotherapy system of the rapidac linear accelerator. The total dose range was 35-65 Gy. The patients in the hyperthermia group were treated with WB-1 type high intensity focused microwave hyperthermia for abdominal irradiation induced by body temperature in patients with diathermy increased to 39. 5-41. 5 ℃and lasted for 60-90 min. The patients in the hyperthermia and radiotherapy group were treated with full body thermotherapy during and successively during the period of radiotherapy. Results The total effective rates of tumor remission（ ORR） in the radiotherapy group and the hyperthermia group（ 3. 3% and2. 9%） was lower than that in the hyperthermia and radiotherapy group（ 13. 5%）（ P〈0. 05）,in which the proportion of urinary system and head and neck tumor were slightly higher. The average overall survival time（ OS） in the hyperthermia and radiotherapy group and the hyperthermia group（ 5. 16 months and 5. 08 months） were lower than that in the radiotherapy group（ 6. 32 months）,but the differences were not significant（ P〈0. 05）,and the proportion of pelvic gynecologic and pulmonary tumors in the patients with slightly higher total survival time in the radiotherapy group was higher. Conclusions In the treatment of relapsed advanced tumor,stereotactic radiotherapy combined with hyperthermia can improve the remission rate,but did not benefit the survival time. The overall survival time of the patients with radiotherapy is slightly higher,and the single palliative treatment（ such as radiotherapy） may be of more practical significance in patients with advanced cancer.
作者
虞喜豪
朴京虎
王咏梅
姜程远
王建平
吴小艳
Yu Xihao;Piao Jinghu;Wang Yongmei;Jiang Chengyuan;Wang Jianping;Wu Xiaoyan(Department of Oncology, 85th Hospital of PLA, Shanghai 200052, Chin)
出处
《临床医学》
CAS
2018年第3期17-20,共4页
Clinical Medicine
关键词
放射治疗
微波热疗
晚期肿瘤
Radiotherapy
Miarowave hyperthermia-therapy
Advanced cancer
