Combined external beam irradiation and external regional hyperthermia for locally advanced adenocarcinoma of the prostate
Combined external beam irradiation and external regional hyperthermia for locally advanced adenocarcinoma of the prostate
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DOI：
10.1016/s0360-3016(97)00109-0
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发表时间：
1997-03-15
影响因子：
7
通讯作者：
Dewhirst, MW
中科院分区：
文献类型：
--
作者：
Anscher, MS;Samulski, TV;Dewhirst, MW
目的：探讨外照射联合局部外热疗治疗前列腺腺癌的安全性和有效性。方法与材料：1987 ~ 1994年对30例局部晚期前列腺癌患者行外照射联合局部热疗治疗。本文报告了21例新诊断（18例）或局部复发（3例）腺癌患者的结果。没有患者有远处转移的证据。前列腺放射治疗总剂量为65-70 Gy，采用四场盒技术。热疗使用环形相控阵微波装置进行，治疗目标是在前列腺内所有测点达到大于或等于42摄氏度的温度。结果：18例新诊断患者中，16例（89%）为T3或T4肿瘤，11例（61%）Gleason评分为7 ~ 9分，平均预处理前列腺特异性抗原（PSA）为69 ng/ml。21例患者中位随访时间为36个月，无一例患者达到瘤内温度均大于或等于42℃的治疗目标，平均CEM 43 T90为2.34 min。36个月无病生存率为25%；18例患者中有12例（67%）复发。唯一有意义的复发预测因子是预处理PSA。无并发症> 3级。结论：尽管无法达到较高的肿瘤温度，但在这群接受放射治疗加热疗的非常晚期局限性前列腺癌患者中，无复发生存率优于大多数单独使用放射治疗的患者。进一步的研究旨在提高对前列腺进行热疗的能力。(C) 1997爱思唯尔科学有限公司
Purpose: To determine the safety and efficacy of combined external beam irradiation and external regional hyperthermia in the treatment of adenocarcinoma of the prostate.Methods and Materials: From 1987 to 1994, 30 patients received combined external beam irradiation and external regional hyperthermia for locally advanced prostate cancer. The results of the 21 patients with newly diagnosed (n = 18) or locally recurrent (n = 3) adenocarcinoma are reported herein. No patient had evidence of distant metastases. Total radiotherapy doses of 65-70 Gy to the prostate were planned using a four-field box technique. Hyperthermia treatments were delivered using an annular phased array microwave device, The treatment goal was to achieve temperatures greater than or equal to 42 degrees C in all measured points within the prostate.Results: Of the newly diagnosed patients, 16 out of 18 (89%) had T3 or T4 tumors, 11 out of 18 (61%) had Gleason scores of 7-9, and the mean pretreatment Prostate Specific Antigen (PSA) was 69 ng/ml. The median follow-up of all 21 patients was 36 months, None of the patients achieved the treatment goal of all intratumoral temperatures greater than or equal to 42 degrees C. The mean CEM 43 T90 was 2.34 min. The disease-free survival at 36 months is 25%; 12 out of 18 (67%) of the patients have relapsed. The only significant predictor of relapse was pretreatment PSA. There were no complications > Grade 3.Conclusions: In spite of the inability to achieve high tumor temperatures, the relapse-free survival rate in this population of patients with very advanced localized prostate cancer treated with radiation therapy plus hyperthermia compares favorably with most series using radiation therapy alone. Further studies aimed at improving the ability to deliver hyperthermia to the prostate are warranted. (C) 1997 Elsevier Science Inc.