螺旋断层放疗联合热疗治疗局部晚期肿瘤或寡转移的疗效观察

摘要

目的 探讨螺旋断层放疗联合热疗治疗局部晚期肿瘤或寡转移的临床疗效及不良反应. 方法 2011-08~2014-06采用螺旋断层放疗联合热疗治疗局部晚期或伴有寡转移患者22 例,热疗采用NRL-002 型内生物肿瘤热疗系统,频率50 MHz,入射功率5 000 W,输出功率2 000 W,治疗时间60 min,加热次数4-10次,每周2次. 热疗在放疗后1 h内进行. 放疗采用Tomothreapy Hi-ART治疗系统,设计单个靶区或多个靶区,均采用靶中靶剂量递增模式. 按照实体瘤的评价标准评价近期疗效,评价指标包括临床症状、体征以及影像学( CT、MRI或PET/CT)等检查结果. 结果 全部病例治疗结束后2-3个月行CT、MRI或PET/CT复查,总有效率(CR+PR)77. 3%,疼痛总缓解率94. 7%,不良反应主要为Ⅰ-Ⅱ度胃肠道反应.结论 螺旋断层放疗联合热疗治疗局部晚期肿瘤或寡转移疗效满意,止痛效果好,不良反应轻.%Objective To investigate the clinical efficacy and adverse reactions of helical tomotherapy combined with hyperthermia for locally advanced cancer or oligometastatic tumor. Methods The clinical data of 22 patients with locally advanced cancer or oligomet-astatic tumor undergoing helical tomotherapy and hyperthermia from August 2011 to June 2014 were collected. The NRL-002 inner bio-logical hyperthermia system included the frequency of 50 MHz, and the input and output powers of 5 000 W and 2 000 W respectively. The treatment time was 60 min for 4-10 times and twice a week. Hyperthermia followed radiotherapy within 1 h. The radiotherapy plan was designed for single or multiple targets using Tomotherapy Hi-ART system and the dose escalation mode. Finally the short-term outcome was evaluated according to the solid tumor evaluation criteria, including clinical syndrome, physical status and CT, MRI or PET/CT results. Results All the patients received CT, MRI and PET/CT scanning 2 -3 months after treatment. Total response rate was 77. 3%, and the rate of pain relief was 94. 7%. Major adverse reactions were grade 1-2 gastrointestinal tract reactions. Conclusion Helical tomotherapy combined with hyperthermia is an effective and satisfied method. This therapeutic regimen has a good effect on pain-relief and no serious adverse reactions.