DEVELOPMENT OF SCANNED FOCUSED ULTRASOUND HYPERTHERMIA - CLINICAL-RESPONSE EVALUATION
DEVELOPMENT OF SCANNED FOCUSED ULTRASOUND HYPERTHERMIA - CLINICAL-RESPONSE EVALUATION
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DOI：
10.1016/0360-3016(91)90705-9
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发表时间：
1991-08-01
影响因子：
7
通讯作者：
CASSADY, JR
中科院分区：
文献类型：
--
作者：
HARARI, PM;HYNYNEN, KH;CASSADY, JR
现在可以通过聚焦和超声对能量沉积模式的控制扫描来实现对深度不规则形状肿瘤的选择性加热。1986年10月至1990年5月，亚利桑那大学开发的扫描聚焦超声(SFUS)热疗系统已用于对71例颅外恶性肿瘤患者的87个肿瘤进行220次治疗。在正在进行的分割放射治疗期间，患者平均每周接受三次SFUS热疗。最常见的解剖部位是骨盆(22例)、胸壁或乳房(14例)、颈部(8例)和腋窝(7例)，而最常见的组织学部位是腺癌(36例)、鳞状细胞癌(11例)和黑色素瘤(10例)。67例SFUS热疗患者同时接受放射治疗(1000~7640cGy量，平均4320cGy量)，4例同时接受化疗。肿瘤体积从1-2100立方厘米(平均325毫升)不等，其中75%位于距皮肤3厘米的深处。观察到62%的总有效率，22%的治疗肿瘤显示完全缓解(定义为治疗后肿瘤完全消失)，40%的治疗肿瘤显示部分缓解(定义为肿瘤体积缩小大于或等于50%)。在接受治疗的肿瘤中，42%的肿瘤局部疼痛显著减轻。SFUS热疗的急性耐受性相当好，在两名患者中发现了慢性毒性(持续性皮肤水泡/烧伤)。讨论了SFUS系统的多功能性，以及其未来改善晚期局部区域恶性肿瘤治疗意图的控制的潜力。
Selective heating of irregularly shaped tumors at depth can now be accomplished through focussing and controlled scanning of energy deposition patterns by ultrasound. A scanned focussed ultrasound (SFUS) hyperthermia system developed at the University of Arizona has been used to deliver 220 treatments to 87 tumors in 71 patients with extracranial malignancies between October 1986 and May 1990. Patients received an average of three SFUS hyperthermia treatments, spaced weekly, during ongoing fractionated radiotherapy. The most common anatomic sites treated were the pelvis (22 patients), chest wall or breast (14), neck (8), and axilla (7), while the most common histologies were adenocarcinoma (36), squamous cell carcinoma (11), and melanoma (10). Concurrent radiotherapy was delivered (range 1000-7640 cGy, mean 4320 cGy) to 67 SFUS hyperthermia patients; 4 received concomitant chemotherapy. Tumor volumes ranged from 1-2100 cubic centimeters (mean 325 cc), and 75% were located at depths > 3 cm from skin. A 62% overall response rate was observed, with 22% of treated tumors demonstrating a complete response (defined as complete disappearance of treated tumor), and 40% exhibiting a partial response (defined as greater-than-or-equal-to 50% reduction in tumor volume). Dramatic local pain reduction was achieved in 42% of the tumors treated. The acute tolerance of SFUS hyperthermia was quite good, and chronic toxicities (persistent skin blisters/burns) were identified in two patients. The versatility of the SFUS system is discussed, as well as its future potential for improving control of advanced loco-regional malignancies treated with curative intent.