Treatment of superficial human neoplasms by local hyperthermia induced by ultrasound
Treatment of superficial human neoplasms by local hyperthermia induced by ultrasound
复制标题
超声局部热疗治疗人体浅表肿瘤
作者：
J. Marmor;D. Pounds;Ted B. Postic;G. Hahn
本研究旨在测试超声局部加热浅表肿瘤的安全性和有效性。25例患者接受了治疗，这些患者的浅表部位复发或转移性肿瘤对传统治疗方式无效。使用2 cm或4 cm压电换能器在1 - 3 MHz频率下产生的高强度超声场进行加热。每次处理将肿瘤保持在43、44或45 ℃中心温度30分钟。在6次治疗后进行反应分析。仔细绘制了超声和热场图。尽管换能器的超声能量输出相对均匀，但注意到肿瘤加热的一些不均匀性。25名患者中有21名在接受26个疗程的局部高温治疗后可进行评估。26个疗程中的14个疗程导致客观肿瘤缓解（54%），但是，大多数缓解是部分缓解，中位随访时间较短（5周），因为许多患者患有全身性疾病并在治疗后死亡或接受化疗。头颈部鳞状细胞癌患者的12个病灶中有8个消退。缓解率与肿瘤中心温度无关。总体而言，治疗耐受性良好，尽管10/26个疗程引起显著的局部疼痛。治疗后疼痛总是消退。26个疗程中有5个导致小（0.5 cm）皮肤烧伤。先前的辐照没有限制加热。我们的结论是，浅表肿瘤可以安全有效地加热超声。单独使用热疗观察到客观肿瘤反应，但我们强调，由于随访时间短，并且大多数反应是部分的，因此观察到的影响可能是暂时的。
This study was designed to test the safety and efficacy of local heating of superficial tumors by ultrasound. Twenty‐five patients were treated who had recurrent or metastatic tumor in superficial locations refractory to conventional treatment modalities. Heating was done with high intensity ultrasound fields produced by a 2 cm or 4 cm piezoelectric transducer at frequencies of 1‐3 MHz. Tumors were held at 43, 44, or 45 C center temperature for 30 minutes each treatment. Analysis of response was done after 6 treatments. Ultrasound and thermal fields were carefully mapped. Some nonuniformity of tumor heating was noted despite relatively uniform output of ultrasound energy by the transducer. Twenty‐one of the 25 patients were evaluable after 26 courses of local hyperthermia. Fourteen of 26 courses of treatment resulted in objective tumor response (54%) However, most responses were partial and median follow‐up time was short (5 weeks) because many patients had systemic disease and died or were put on chemotherapy after treatment. Eight of 12 lesions in patients with squamous cell carcinoma of the head and neck regressed. Response rate did not correlate with central tumor temperature. Treatment was, in general, well tolerated although 10/26 courses of treatment caused significant local pain. Pain always subsided after treatment. Five of 26 courses of treatment resulted in small (0.5 cm) cutaneous burns. Previous irradiation did not limit heating. We conclude that superficial tumors can be safely and effectively heated by ultrasound. Objective tumor responses were seen with hyperthermia alone, although we stress that, because of the short follow‐up time and, because most responses were partial, it is likely that the effects noted were transitory.