高温热疗加放射粒子植入及化疗治疗转移性盆腔肿瘤

Hyperthermia in combination with interstitial radiotherapy and chemotherapy in the treatment of metastatic pelvic cancer

目的 观察高温热疗加放射粒子植入及化疗治疗转移性盆腔肿瘤的疗效。方法 将转移性盆腔肿瘤患者分为A、B两组,A组19例,B组22例。A组给予射频加热的同时从电极处灌注2.5％的盐水以扩大肿瘤凝固性坏死的范围。不能热疗的肿瘤边缘组织内植入碘-125粒子。术后第15天开始化疗。奥沙利铂100 mg/m2,静脉滴注,第1天;CF 200 mg/m2,在5-Fu滴注前经静脉滴注2 h,继以5-Fu 200 mg/m2经静脉推注,5-Fu 400 mg/m2经静脉滴注22 h,连续5 d,3周为1周期。B组只给予化疗,化疗用药、剂量及天数与A组相同。结果 第6个周期末,A组与B组的有效率分别为84.2％和36.4％,两组有效率比较差异有显著性(P<0.01)。两组的毒副反应发生率差异无显著性。结论 高温热疗加放射粒子植入及化疗治疗转移性盆腔肿瘤的近期疗效好,并发症少。

Objective To observe the efficacy of hyperthermia in combination with interstitial radiotherapy and chemotherapy in the treatment of metastatic pelvic cancer. Methods Forty-one patients were divided into group A and group B. For nineteen patients in group A, a perfusion electrode was introduced into the center of tumor and the tumor was coagulated with radiofrequency energy. The electrode was used to perfuse 2.5% saline (120 ml/ hour) during coagulation to increase the volume of coagulation necrosis.The iodine-125 granules were implanted in the margin of the tumor which can not be coagulated by hyperthermia. Chemotherapy was started on the fifth day after the treatment with hyperthermia and implantation of the iodine-125 granules. Oxaliplatin 100 mg/m2 as a 2-hour infusion on day 1,leucovorin 200 mg/(m2·d) as a 2-hour infusion followed by abolus of 5-Fu 200 mg/(m2·d) and a 22-hour infusion of 5-Fu 400 mg/(m2·d) for 5 consecutive days. Treatment was repeated every 3 weeks. Twenty-two patients in group B were only given chemotherapy, and the drugs and doses were same as the group A. Results The response rates of group A and group B were 84.2% and 36.4% respectively at the end of the sixth cycle,with a significant difference between group A and group B(x2 = 7.74, P < 0.01) .There was no difference in toxicity between the group A and the group B. Conclusion Hyperthermia in combination with interstitial radiotherapy and chemotherapy were effective in the treatment of metastatic pelvic cancer. There were few complications.