CLINICAL RESEARCH OF THREE-DIMENSIONAL CONFORMATION RADIOTERERAPY COMBINED WITH HYPERTHERMIAIN EXPECTING ITS RADIOSENS1TIZATION EFFECTS FOR LOCALLY ADVANCED AND POSTOPERATIVE RECURRENT TUMORS

三维构象放射治疗联合热疗对局部晚期及术后复发肿瘤放射增敏作用的临床研究

• 批准号: 18591394
• 负责人: TANAKA Yoshiaki
• 金额: $ 1.95万
• 依托单位: Nihon University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2006
• 资助国家: 日本
• 起止时间: 2006 至 2007
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-18591394/
• 关键词: Radiation therapy; 3-D conformal radiotherapy; Hyperthermia; Chemotherapy; Radiosensitization; Digestive organ carcinoma; Locally advanced carcinoma; Recurrent tumors; 癌集学的治療; QOL; 癌; 臨床研究; 原体照射

In radiation therapy (RT), it is generally difficult to obtain satisfactory treatment effects for the locally advanced and postoperative recurrent tumors. Then, a combination modality comprising of three-dimensional conformation radiotherapy (3D-CRT) and hyperthermia (HT) was applied to these tumors in their distinctive characteristics of dose distribution and radiosensitization effects.From January 2003 through December 2006, 25 patients (18 males and 7 females) were enrolled for this clinical study. They included carcinoma of the pancreas (8), gallbladder (2), bile duct (4), small bowel (2), sigmoid (2), and rectum (7) and distributed with an age between 43 and 80 years (59.4. in average). They were grouped by their present status as locally advanced (inoperable) cases (12), post-operative recurrent cases (12) and the other one (1). RT was mainly performed with a technique of 3D-CRT. The prescribed dose was 50-60 Gy with a conventional fractionation schedule. HT was applied once a we … More ek with a total of four or more sessions by means of RF-capacitive heating device (Thermotmn-RF8) with a therapeutic temperature of 41℃ or more and treatment time of 30 min. or more. Almost patients received concurrent chemotherapy (CT)comprising of GEM (800-1000mg) for pancreatic cancer and 5-FU/LV, UFT, TS-1 or FOLFOX for colorectal cancer. The treatment was able to be performed in full manner in 17/25 (68%), when it was evaluated under the condition that more than 70% of the treatment protocol had been done. As for completion ratio of the treatment, it was higher in the pancreas (7/8) and colorectal sites (7/9) than in other lesions. Local responses evaluated by the diagnostic imaging and clinical symptoms showed "excellent" in 7, "good" in 12 and "no-response" in 6, which meant 76% in response rate. Regarding treatment organs, it was higher in the pancreas (6/8) and the colorectal sites (8/9) than in the bile duct (4/6) or the small bowel (1/2). From a view point of condition of treatment performances, the number of cases showing "excellent", "good" and "no-response" was 6, 10, and 1, respectively, in the completely performed group and 1, 2 and 6, respectively, in the incompletely performed group, which was higher in the former group than in the latter one (94% vs 38%). 3D-CRT combined with HT showed an improvement of QOL (quality of life) including pain relief and decrease in amount of abnormal excretion. In toxicity, local pain and discomforts were occurred on the patients with obvious subcutaneous fat layer and a condition of colostomy constructed. Gastric ulcer was observed in 2 out of 8 patients with pancreatic cancer.In conclusions, 3D-CRT combined with HT and CT was evaluated as an effective treatment modality, especially applied to the patients with locally advanced pancreatic cancer and postoperative recurrent colorectal cancer. Less

在放射治疗（RT）中，局部晚期及术后复发肿瘤通常难以获得满意的治疗效果。然后，将三维构象放疗（3D-CRT）和热疗（HT）的联合模式应用于这些肿瘤，以其剂量分布和放射致敏效应的独特特征。从2003年1月到2006年12月，25名患者（18名男性和7名女性）被纳入这项临床研究。包括胰腺癌（8例）、胆囊癌（2例）、胆管癌（4例）、小肠癌（2例）、乙状结肠癌（2例）和直肠癌（7例），年龄分布在43 - 80岁之间（59.4%）。在平均)。根据病情分为局部晚期（不能手术）12例，术后复发12例，其余1例。RT主要采用3D-CRT技术。处方剂量为50-60戈瑞，采用常规分离方案。采用射频容性加热装置（thermomn - rf8），治疗温度为41℃或更高，治疗时间为30分钟或更长，每两周应用一次，共四次或更多次。几乎所有患者都接受了同步化疗（CT），包括胰腺癌的GEM （800-1000mg）和结直肠癌的5-FU/LV、UFT、TS-1或FOLFOX。在17/25（68%）中，当在超过70%的治疗方案完成的情况下进行评估时，治疗能够完全进行。在治疗完成率方面，胰腺（7/8）和结直肠（7/9）高于其他病变。通过诊断影像及临床症状评价局部反应：“优”7例，“良”12例，“无”6例，有效率76%。在治疗器官方面，胰腺（6/8）和结肠（8/9）高于胆管（4/6）和小肠（1/2）。从治疗效果情况看，完全执行组“优”、“良”、“无反应”分别为6例、10例、1例，不完全执行组分别为1例、2例、6例，前者高于后者（94%比38%）。3D-CRT联合HT显示生活质量的改善，包括疼痛缓解和异常排泄量的减少。在毒性方面，皮下脂肪层明显的患者出现局部疼痛和不适，建立了结肠造口条件。8例胰腺癌患者中2例出现胃溃疡。综上所述，3D-CRT联合HT和CT是一种有效的治疗方式，尤其适用于局部晚期胰腺癌和术后复发结直肠癌患者。少

项目成果

Historical review of the past forty-years in the research of clinical radiology (in Japanese)

临床放射学研究四十年历史回顾（日文）

• 发表时间: 2007
• 期刊: Nihon University J. Medicine 66(4)
• 作者: Tanaka;Y
• 通讯作者: Y

温熱併用放射線療法を施行した十二指腸癌術後再発の一例

十二指肠癌热疗及放射治疗后复发一例

• 发表时间: 2006
• 期刊: 日本ハイパーサーミア学会誌 22・2
• 作者: 鈴木 実;田中浩基;菓子野元郎;他3名;齊藤友也;鈴木実;Tanaka Y;鈴木実;齋藤 勉;鈴木実;齋藤 勉;鈴木実;齋藤 勉;前林 俊也;前林 俊也
• 通讯作者: 前林 俊也

聴神経腫瘍に対する少分割定位放射線治療

大分割立体定向放射治疗听神经瘤

• 发表时间: 2006
• 期刊: 日本放射線腫瘍学会誌 18・(Suppl.)
• 作者: 鈴木 実;田中浩基;菓子野元郎;他3名;齊藤友也;鈴木実;Tanaka Y;鈴木実;齋藤 勉;鈴木実;齋藤 勉;鈴木実;齋藤 勉;前林 俊也;前林 俊也;田中 良明;Maebayashi T;藤井 元彰
• 通讯作者: 藤井 元彰

Hypofractionated stereotactic radiotherapy for acoustic neurinoma (in Japanese)

听神经瘤的大分割立体定向放射治疗（日语）

• 发表时间: 2006
• 期刊: J. Jpn. Soc. Then Radiol. Oncol 18
• 作者: Fujii;M
• 通讯作者: M

A case of synovial sarcoma originated from pleural cavity with a good initial response obtained by hyperthermo-chemo-radiotherapy (in Japanese)

胸膜腔滑膜肉瘤经高温化疗放疗初期疗效良好一例（日文）

• 发表时间: 2008
• 作者: Maebayashi;T
• 通讯作者: T