调强适形放疗同步化疗联合内生场热疗治疗复发和局部晚期直肠癌的近期疗效

Clinical observation of intensity- modulated conformal radiotherapy with concurrent chemotherapy and endogenic field hyperthermia for locally recurrent or advanced rectal cancer

目的探讨调强适形放疗(IMRT)联合同步化疗及内生场热疗治疗复发和局部晚期直肠癌的近期疗效及安全性。方法 60例均为经病理证实的复发或局部晚期直肠癌随机分为同步放化疗联合热疗治疗的A组(n=30)和同步放化疗治疗的B组(n=30)。两组放疗方式和化疗方法均相同,A组于放疗后1 h内加用NRL-004型内生场肿瘤热疗系统热疗。治疗结束后3个月评估近期疗效和近期不良反应,随访评估远期疗效。结果A组总有效率(90.0%)高于B组(66.7%),差异有统计学意义(2=4.812,P<0.05)。两组疾病控制率均为100%。KPS评分、局部疼痛缓解率及各类不良反应比较差异均无统计学意义(P>0.05)。结论 IMRT同步Cape OX化疗联合内生场热疗治疗复发和局部晚期直肠癌可有效提高近期疗效、改善生活质量,且不增加不良反应,值得进一步研究。

Objective This study aims to determine the short-term efficacy and safety of intensity-modulated conformal radiotherapy with concurrent chemotherapy and endogenic field hyperthermia for locally recurrent or advanced rectal cancer.Methods Sixty patients with locally recurrent or advanced rectal cancer were randomly divided into two groups, the radiochemotherapy with hyperthermia group （ Group A with 30 patients ） and the radiochemotherapy group （ Group B with 30 patients） .Patients in the two groups received chemoradiotherapy of the same regimen, while patients in Group A underwent additional treatment of endogenic field hyperthermia （ Tumor Endogenic Field Hyperthermia System, Model NRL-004） within 1h after radiotherapy.Efficacy and safety outcomes were evaluated 3 months after the end of all treatments.Further follow -up was implemented for long -term efficacy.Results The effective rate of Group A （90.0%） was higher than that of Group B （66.7%） （χ2 =4.812, P〈0.05）.Disease control rate was 100% in both groups.There was no significant difference in KPS score, rate of local pain relief or frequency of adverse reactions （ P〉0.05）.Conclusion Intensity modulated conformal radiotherapy with concurrent CapeOX chemotherapy and endogenic field hyperthermia for locally recurrent or advanced rectal cancer improves short-term efficacy and quality of life while the adverse reaction remained mild.Further study is advisable.