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

在放射治疗（RT）中，对于局部晚期和术后复发的肿瘤通常难以获得满意的治疗效果。2003年1月至2006年12月，25例患者（男18例，女7例）接受了三维适形放疗（3D-CRT）和热疗（HT）的联合治疗。其中胰腺癌8例，胆囊癌2例，胆管癌4例，小肠癌2例，乙状结肠癌2例，直肠癌7例。平均）。按其目前状态分为局部晚期（不可手术）病例（12例）、术后复发病例（12例）和其他1例（1例）。RT主要采用3D-CRT。处方剂量为50-60戈伊，采用常规分次方案。HT应用一次， ...更多信息 通过射频电容加热装置（Thermotmn-RF 8）进行治疗，治疗温度为41℃或更高，治疗时间为30分钟或更长，共进行四次或更多次治疗。大部分患者同时接受化疗（CT），包括胰腺癌的GEM（800- 1000 mg）和结直肠癌的5-FU/LV、UFT、TS-1或FOLFOX。当在治疗方案完成70%以上的条件下进行评价时，17/25例（68%）患者能够以完全方式进行治疗。胰腺（7/8）和结直肠（7/9）的治疗完成率高于其他病变。根据影像学和临床症状评价，优7例，良12例，无效6例，有效率为76%。关于治疗器官，胰腺（6/8）和结直肠部位（8/9）的比例高于胆管（4/6）或小肠（1/2）。从治疗效果的情况来看，完全执行组中显示“优”、“良”和“无反应”的病例数分别为6例、10例和1例，不完全执行组中分别为1例、2例和6例，前者高于后者（94% vs 38%）。3D-CRT联合HT治疗组患者的生活质量（QOL）明显改善，疼痛减轻，异常排泄物减少。毒性反应主要表现为皮下脂肪层明显、需造口的患者出现局部疼痛和不适。8例胰腺癌患者中2例出现胃溃疡。结论：3D-CRT联合HT和CT是一种有效的治疗方法，尤其适用于局部晚期胰腺癌和结直肠癌术后复发的患者。少

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