复治晚期消化道肿瘤全身热疗配合精确放射治疗的作用价值观察

The Value and Significance Observation of Effect on Hyperthermia-Therapy Adjuvant Stereotaxic Radiotherapy in the Treatment of Re-Treating Advanced Digestive Tract Tumor

目的:探讨采用精确放疗联合全身热疗在复治晚期消化道肿瘤治疗中的作用价值及意义。方法:以回顾性研究方式,收集整理资料较完整的114例患者的相关临床资料。按接受的主要治疗分为单纯放疗组(A) (74例);放疗联合热疗组(B) (20例),单纯热疗为主组(C) (20例)。放射治疗主要采用60Co伽马刀放射系统及Rapidac直线加速器精确放疗,热疗采用WB-1型高能微波热疗机腹部头热全身热疗(治疗体温39.5℃~41.5℃),联合治疗组以放射治疗周期间同步实施热疗。结果:近期肿瘤缓解率ORR以放疗联合热疗组较高(15%),其中以食管癌疗效略优(15.8%),然而生存分析中,总平均生存期(OS)及中位生存期(MST)均以单纯放疗组为高,分别为7.7个月、5个月。K-M生存曲线显示单纯放疗组的OS较放疗联合热疗组及单纯热疗组差异有统计学意义。结论:在复治的晚期消化道空腔脏器放疗及辅以全身热疗治疗中,放疗热疗联合治疗略可提高肿瘤缓解率,但仅单纯放疗有较好的生存获益,较后者有更实际的临床意义。

Objective: To investigate the effect significance of hyperthermia-therapy adjuvant stereotaxic body radiotherapy (SBRT, Gamma-knife/accelerator) in the treatment of patients with re-treating digestive tract advanced cancer. Method: Collect clinical data of patients who received stereotactic radiotherapy and whole body hyperthermia treatment in a retrospective way. According to the relevant clinical data of 114 patients with relatively complete data, they were divided into radiotherapy group (A) (74 cases);radiotherapy combined with hyperthermia group (B) (20 cases), and hyperthermia-based group (C) (20 cases). Radiation therapy mainly uses 60Co gamma knife radiation system and Rapifac linear accelerator for preciseradiotherapy. Hyperthermia adopts WB-1 type high-energy microwave hyperthermia machine and whole body hyperthermia of the abdomen and hed (the treatment body temperature is 39.5˚C~41.5˚C), and the combined treatment group implements hyperthermia simultaneously during the radiation therapy week. Result: The recent tumor response rate ORR was higher in the radiotherapy combined with hyperthermia group (15%), among them, the curative effect of esophageal. However, in the survival analysis, the overall mean survival (OS) and median survival (MST) were higher in the radiotherapy group, which were 7.7 months and 5 months, respectively. The K-M survival curve showed that the OS of the radiotherapy group was significantly different from the radiotherapy combined hyperthermia group and the hyperthermia group alone. Conclusion: In the retreatment of advanced gastrointestinal cavity organ radiotherapy and supplemented by whole body hyperthermia, the combined treatment of radiotherapy and hyperthermia can slightly increase the tumor remission rate. However, only radiotherapy alone has a better survival benefit, and has more practical clinical significance than the latter.