An assessment of local hyperthermia in clinical practice.
An assessment of local hyperthermia in clinical practice.
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临床实践中局部热疗的评估。
DOI：
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发表时间：
1986
影响因子：
3.1
通讯作者：
S. B. Field
中科院分区：
文献类型：
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作者：
P. Dunlop;Jeffrey W. Hand;Robert Julian Dickinson;S. B. Field
在 I/II 期研究中，总共有 116 个小型浅表肿瘤通过单独放疗、单独热疗或放疗和热疗相结合进行了治疗。大多数肿瘤是乳腺腺癌的转移或局部复发，但也涉及其他组织学，包括黑色素瘤。热疗主要通过微波进行，但也使用射频和超声波方法。基于侵入式多点热电偶阵列测量的严格热剂量测定表明，58% 的高温治疗在肿瘤内达到了相当于 43 摄氏度 20 分钟的最小剂量 (minEq43)； 24% 的人达到至少 60 minEq43。在加热的 75 个肿瘤中，有四分之一在每个预期场合都成功实现了 20 minEq43 的最小值，在 39 个肿瘤中则成功实现了一次/两次；不幸的是，在 17 个（23%）肿瘤的任何热疗过程中监测到的任何点都没有达到这个最低阈值。接受辐射和有效热疗的肿瘤比接受辐射但加热不充分的肿瘤（CR率35%）（P小于0.001）或仅接受相同剂量的辐射（CR率35%）（P小于0.05）更有可能完全消失（CR率86%）。热疗的这种改善在次优辐射剂量下变得更加明显。仅由热量造成的生长延迟虽小但可测量，且完全缓解率较差（11%）。热剂量单位在临床实践中的实时使用有利于高温治疗的比较，并为检查热输送系统的技术性能提供了重要参数。这项研究的结果强调需要改善肿瘤内温度分布，以便建立最低阈值温度以提高肿瘤反应率。
A total of 116 small superficial tumours have been treated by radiation alone, hyperthermia alone, or radiation and hyperthermia combined in a Phase I/II study. Most tumours were metastases or local recurrences of adenocarcinoma of breast but other histologies were involved including melanoma. Hyperthermia was delivered predominantly by microwaves, but radiofrequency and ultrasound methods were also used. Rigorous thermal dosimetry, based on measurements from invasive multipoint thermocouple arrays, has shown that 58 per cent of hyperthermal treatments reached a minimum dose within tumour equivalent to 20 min at 43 degrees C (minEq43); 24 per cent reached at least 60 minEq43. Minima of 20 minEq43 were achieved successfully on every intended occasion in a quarter of the 75 tumours heated, and on one/two occasions in 39; unfortunately, this minimum threshold was not reached at any point monitored at any hyperthermia session in 17(23 per cent) tumours. Tumours that received radiation and effective hyperthermia were more likely to disappear completely (CR rate 86 per cent) than those that were irradiated but inadequately heated (CR rate 35 per cent) (P less than 0.001) or were treated by the same doses of radiation alone (CR rate 35 per cent) (P less than 0.05). This improvement with hyperthermia became more apparent with suboptimal radiation doses. A small but measurable growth delay was imposed by heat alone with a poor complete response rate (11 per cent). The real-time use of a thermal dose unit in clinical practice facilitates hyperthermal treatment comparisons and provides an important parameter for checking the technical performance of a heat delivery system. The results of this study emphasizes the need for improvements in intratumour temperature distribution, in order to establish minimum threshold temperatures to enhance tumour response rates.