Combined treatment of 8 MHz radiofrequency hyperthermia and irradiation in a patient with mediastinal metastases of renal cancer

A combined therapy of irradiation and 8 MHz radiofrequency hyperthermia using the Thermotron-RF Model 8 was performed on a patient with mediastinal metastasis of renal cancer. The patient was a 74-year-old male, who received left transperitoneal nephrectomy for left renal tumor in December, 1982. Histology report indicated clear cell carcinoma of the kidney. He noticed puffy face and dyspnea in April, 1984. A CT scan showed a mediastinal tumor 57 X 43 X 120 mm in size and right pleural effusion. Aspiration biopsies revealed metastatic adenocarcinoma of the mediastinal lymph nodes. The combined therapy of irradiation and 8 MHz radiofrequency hyperthermia was started in July, 1984. He was irradiated with daily 2.0 Gy, 5 times a week and was heated twice a week within one hour after each irradiation, totally 50 Gy of irradiation and 14 sessions of hyperthermia. After the treatment, 69% tumor regression and disappearance of pleural effusion were obtained. The combined therapy with 28.8 Gy of irradiation and 7 sessions of hyperthermia was added for the regrowth of the tumor in February, 1985. A 30% of tumor regression was achieved, however, there was no improvement of the dyspnea or pleural effusion. He died on April 8, 1985.     

A combined treatment with 8 MHz radiofrequency hyperthermia, HPC-adriamycin, immunotherapy, radiation, systemic chemotherapy and irradiation for invasive bladder carcinoma

Hyperthermia was induced for the treatment of invasive bladder carcinoma in order to study its usefulness. The subjects were 12 cases of invasive bladder cancer; including 5 cases of T2, 3 cases of T3, 2 cases of T4, and 2 cases of recurrence after total cystectomy. As previous treatment, 4 patients received radiotherapy and the other received TUR, systemic chemotherapy, and intravesical injection of anticancer drugs. For hyperthermia treatment, a Thermotron RF-8 was used for heating a deep seated tumor. Each case received hyperthermia 2 to 10 times. Combined therapy included injection of HPC-adriamycin into the urinary bladder in 5 cases, immunotherapy in 3 cases, M-VAC therapy in one case, radiotherapy in one case, radiotherapy and intra-arterial injection in one case, and Peplomycin and OK-432 local injection in one case. The treatment results showed a 75% effectiveness; with CR in 4 cases, PR in 5 cases, MR in 2 cases and PD in one case. Three patients died and 9 survived. Of four patients who had received radiotherapy as a previous treatment 3 cases obtained CR and one case MR. Therefore, it was considered that a favorable treatment effect with hyperthermia could be obtained after radiotherapy.     

Palliation of advanced head and neck cancer with radiofrequency hyperthermia and cytotoxic chemotherapy

Fourteen patients with recurrent malignant tumours of the head and neck were treated with radiofrequency hyperthermia and chemotherapy after conventional therapy had failed. After 2 to 11 treatment courses and a follow-up of 30 weeks, the neoplasms in three patients had completely regressed and one had a partial response. Of eight patients who died, two had partial responses initially; a third patient died of complications relating to surgical resection of the tumour after a partial response. Three of five patients whose tumours were unresponsive to methotrexate responded when this drug was given with radiofrequency hyperthermia. There were seven minor skin burns in six patients. Further studies of radiofrequency hyperthermia and chemotherapy for palliation of head and neck cancer are planned.     

晚期腹腔肿瘤热灌注化疗并射频高温治疗的剂量学与疗效分析

目的探讨晚期腹腔肿瘤腹腔热灌注化疗并射频(RF)加温时的温度剂量与疗效的关系。方法回顾分析本组在2001年1月-2002年5月,治疗的各类腹腔晚期转移性恶性肿瘤56例,所有患者均接受1～8次腹灌 RF 化疗。用RF对腹腔加温,测量腹腔及直肠温度。结果2点测温的患者82%(23/28例)腹腔温度达到40℃,3点测温68%(19/28例)达到40℃,腹腔与直肠温度基本相近。热剂量学指标与疗效分析显示,治疗次数、Tmax和Eq.40℃是影响患者的6个月存活率的主要因素。热灌注化疗 RF具有较好的止痛效果,毒副作用少。结论腹腔热灌注合并RF加温及化疗对晚期腹腔肿瘤患者有良好效果,建议治疗剂量应达到:腹腔Tmax温度在40℃以上,>40℃的时间>40min,治疗次数在4次以上。我们提出的剂量指标Eq.40℃.min,包含了腹腔温度39.5-42℃的全部生物效应,值得进一步使用和验证。     

支气管动脉化疗灌注联合多极射频治疗中晚期肺癌

目的评价支气管动脉化疗灌注联合多极射频治疗中晚期肺癌的临床疗效。方法对32例失去手术机会或放弃手术治疗的中晚期肺癌患者,在进行常规支气管动脉化疗灌注的同时,于首次化疗灌注后2周,在CT引导下对病灶进行多极射频治疗1次。随访并记录术后半年、1年、2年、3年的有效率与患者生存率,与单纯进行常规支气管动脉化疗灌注的38例对照组进行同期有效率与生存率的比较。结果联合治疗组术后半年、1年、2年、3年的有效率/生存率分别为:87.5%/96.9%、71.9%/81.3%、34.4%/46.9%、12.5%/21.9%。对照组有效率/生存率分别为:63.2%/78.9%、36.9%/52.6%、26.3%/36.8%、5.3%/7.9%,联合治疗组有效率与生存率均明显高于对照组,统计学有明显差异(P<0.05)。结论支气管动脉化疗灌注联合多极射频治疗中晚期肺癌,疗效明显优于单纯支气管动脉化疗灌注(P<0.05),同时可明显提高患者的生存率,是一种较为理想、安全有效的综合性治疗手段,值得推广应用。     

TACE分别联合放射性125I粒子植入与射频消融治疗乏血供肝癌

目的探讨TACE联合放射性~(125)I粒子植入与TACE联合经皮射频消融(RFA)治疗乏血供肝癌的临床疗效。方法回顾性分析46例乏血供肝癌患者资料,其中25例(30个病灶)接受TACE联合放射性~(125)I粒子植入治疗(A组),21例(27个病灶)接受TACE联合RFA治疗(B组)。比较两组疗效及并发症情况。结果治疗后3个月,B组临床有效率(RR)为96.30%(26/27),明显高于A组[86.67%(26/30),χ~2=8.694,P0.05];直径≤3cm的病灶中,A、B组的RR均为100%(8/8、10/10);在直径3~5cm的病灶中,A、B组的RR分别为81.82%(18/22)、94.12%(16/17),差异无统计学意义(χ~2=5.837,P0.05)。治疗后6个月,A、B组的RR分别为93.33%(28/30)、96.30%(26/27),差异无统计学意义(χ~2=3.422,P0.05);直径≤3cm的病灶中,A、B组的RR均为100%(8/8、10/10);直径3~5cm的病灶中,A、B组的RR分别为90.91%(20/22)、94.12%(16/17),差异无统计学意义(χ~2=2.716,P0.05)。两组术后并发症差异无统计学意义(P均0.05),均未出现严重并发症。结论 TACE联合放射性~(125)I粒子植入与TACE联合RFA均为乏血供肝癌安全、有效的治疗方法,TACE联合RFA相对近期疗效更优。     

Interleukin-2 and interferon-alpha2b as a daily alternating schedule in advanced renal cell cancer

Summary Interferon-alpha (IFN-) and interleukin-2 (Il-2) are effective as single agents in metastatic renal cell cancer (RCC) with response rates of 15–30%. Additionally, IFN- is assumed to act synergistically with Il-2 in the induction of lymphokine-activated killer cells. (LAK cells) in vitro. With the aims of increasing the response rate by combining both cytokines and of reducing side effects, we started a clinical trial with a daily alternating schedule of 10×10⁶ units/m² s.c. rIFN-_2b (Essex, Munich, FRG) and 3×10⁶ Cetus units/m² rIL-2 (EuroCetus, Frankfurt, FRG) in the form of 1 h infusions over a period of 14 days. Patients found to have progressive disease after two cycles of therapy were withdrawn from the study; patients with stable disease or better received two further cycles.Of the 27 patients included in the study, 22 (16 male, 6 female) are evaluable for response. In 1 patient with multiple pulmonary metastases complete remission was achieved, in 5 patients partial remission, and in 2 a minor response. The schedule was practicable; the main side effects were influenza-like symptoms, fatigue and hypotension. Some patients suffered from arthralgias and erythemas up to 3 weeks after finishing the therapy cycle. On the whole, the side effects seem to be less severe than those arising from schedules using continuous Il-2 infusions.This work was supported by Grant No. 01GA8802 of the Bundesministerium für Forschung und Technologie (BMFT)     

A phase II trial of melphalan or thioguanine in the treatment of patients with advanced renal cell cancer

Sixty-one ambulatory patients with advanced or unresectable renal carcinoma were treated with either melphalan (41 patients) or thioguanine (20 patients). Two objective partial responses were observed in the melphalan cohorts for a response rate of 4.9% (exact 95% confidence interval, 1-17%). No patients treated with thioguanine responded. One patient died of hemorrhage on the melphalan arm. There were no treatment-related deaths on the thioguanine arm. Other than the one death, there were no unexpected or irreversible toxicities. Myelosuppression was the most frequent toxicity. These agents have no meaningful activity in the treatment of advanced renal cell carcinoma.     

经导管肾动脉化疗栓塞联合射频消融术治疗肾癌的疗效分析

目的评价TACE联合射频消融术(RFA)治疗肾癌的疗效。方法回顾性分析我中心收治的23例肾癌患者资料。全部患者均首先行肾TACE治疗,并在3~4周后在超声及CT的联合引导下行RFA术。评价患者术前术后的卡氏功能状态评分(KPS评分)及肾功能变化情况,同时在随访期内定期对患者行腹部超声、CT/MR增强扫描评价其疗效。结果至随访终止,全部23例患者中生存21例(21/23,91.30%),死亡2例(2/23,8.70%)。全部患者在术前和随访期结束时的KPS评分及血肌酐水平差异无统计学意义(P均0.05)。至随访结束,23例患者肾内病灶的治疗效果为完全缓解16例、部分缓解5例、进展2例。结论 TACE联合RFA治疗肾癌创伤小、疗效确切、围术期并发症少,是一种较为安全有效的方法。     

Nephrectomy combined with perioperative alpha-interferon in the treatment of advanced local and minimally metastatic renal cell cancer

alpha-Interferon produces a 15% response lasting on average 4-6 months in renal cell carcinoma, providing little justification for use as adjuvant treatment. Two observations, however, suggest that the benefits might be greater than predicted. In our studies in patients with small volume lung disease 59% responded (2 + 8/17) compared to 3% (0 + 2/64) for more advanced disease. Secondly, an animal intravenous metastasis model has shown a critical window of 24 h around the time of injection of tumour cells when treatment with interferon Ca produces durable complete remissions. In an attempt to capitalise on this observation, a feasibility study has been initiated to establish the safety of perioperative interferon. Patients received 3 MU daily for 3 days prior to operation and for 2 weeks after operation. Thirteen patients have been treated and all except one were discharged from hospital within 2 weeks. There have been two serious problems in the immediate post-operative period, one developed septicaemia and one had an episode of hypotension secondary to post-operative blood loss. One partial remission and one minor response was noted in the 9 patients with metastases and none showed accelerated tumour growth post-operatively. It is concluded that this approach is safe enough to be included in a randomised trial.     

Preoperative hyperthermia combined with radiochemotherapy in locally advanced rectal cancer: a phase II clinical trial.

OBJECTIVE: A prospective phase II study was performed to determine the feasibility and efficacy in terms of response rate, resectability, and morbidity in patients with locally advanced rectal cancer who received preoperative regional hyperthermia combined with radiochemotherapy (HRCT). SUMMARY BACKGROUND DATA: Recent studies suggest that preoperative radiochemotherapy in locally advanced rectal cancer can induce downstaging, but after resection the incidence of local recurrences remains high. Hyperthermia (HT) may add tumoricidal effects and improve the efficacy of radiochemotherapy in a trimodal approach. PATIENTS AND METHODS: Thirty-seven patients with histologically proven rectal cancer and T3 or T4 lesions, as determined by endorectal ultrasound and computed tomography, entered the trial. 5-Fluorouracil (300-350 mg/m2) and leucovorin (50 mg) were administered on days 1 to 5 and 22 to 26. Regional HT using the SIGMA 60 applicator (BSD-2000) was given once a week before radiotherapy (45 Gy with 1.8-Gy fractions for 5 weeks). Surgery followed 4 to 6 weeks after completion of HRCT. RESULTS: Preoperative treatment was generally well tolerated, with 16% of patients developing grade III toxicity. No grade IV complications were observed. The overall resectability rate was 32 of 36 patients (89%), and 31 resection specimens had negative margins (R0). One patient refused surgery. In 5 patients (14%), the histopathologic report confirmed no evidence of residual tumor (pCR). A partial remission (PR) was observed in 17 patients (46%). The survival rate after 38 months was 86%. In none of the patients was local recurrence detected after R0(L), but five patients developed distant metastases. CONCLUSION: Preoperative HRCT is feasible and effective and may contribute to locoregional tumor control of advanced rectal cancer, which is to be proven in an ongoing phase III trial.     

Combined treatment with by-pass operation,irradiation and immunochemotherapy for advanced thoracic esophageal cancer

Based on the experimental results that operative stress of thoracotomy or laparothoracotomy has enhanced tumor growth remarkably in rats compared with laparotomy, a new combined treatment with by-pass operation, irradiation and immunochemotherapy was investigated in 39 advanced thoracic esophageal cancer patients. At by-pass operation, abdominal esophagus was divided and its proximal stump was closed immediately. Cervical esophagus was then divided and its distal stump was pulled out to the right supraclavicular region to make outer fistula. Thus, anticancer drug was poured into the esophagus through outer fistula very easily just before irradiation and then irradiation was performed under the condition that the lesion was immersed in the drugs. As anticancer agent, Mitomycin-C, 5-Fluorouracil or Bleomycin was given alternately. Lately, the combination of 5-Fluorouracil and Vitamin A was preferably used. The changes of immunological parameters and the survival after the onset of treatment was reported. Supported in part by Grant-in-Aid for Cancer Research from the Ministry of Education, Science and Culture.     

Preoperative combined treatment with radiation,intraluminal hyperthermia,and 5-fluorouracil suppositories for patients with rectal cancer

A clinical trial of a novel modality consisting of preoperative irradiation and intraluminal hyperthermia therapy, with or without 5-fluorouracil (5-FU) suppositories, was conducted on 30 patients with rectal cancer. To create hyperthermia in rectal cancer, an intraluminal electrode connected to a radiofrequency system was devised. Patients were treated preoperatively with a total irradiation dose of 30 Gy, being 3 Gy every 2 days, and 5 applications of hyperthermia given twice a week, with or without 5-FU suppositories, given as 100 mg a day to a total of 2,000 mg. Twenty patients received irradiation, intraluminal hyperthermia, and 5-FU suppositories, being the three-combination treatment, and the remaining 10 received irradiation and intraluminal hyperthermia, being the two-combination treatment. Shrinkage of the rectal cancer was observed macroscopically in 26 patients, resulting in a flattened cancerous crater or shallow ulcer. Microscopic examination revealed a marked decrease in the number of cancer cells. In fact, three resected specimens showed no evidence of cancer cells microscopically. These striking reductions in cancer size enabled us to successfully perform super-low anterior resections in four patients, with anastomoses being made just above the dentate line with a sufficiently safe margin. No serious complications were encountered in this series.     

培美曲塞联合华蟾素为晚期或转移性乳腺癌患者一线治疗的疗效和安全性

目的观察培美曲塞联合华蟾素治疗晚期或转移性乳腺癌患者的的疗效和安全性。 方法选取2012年2月至2016年4月间武汉市黄陂区人民医院外科收治的晚期或转移性乳腺癌女性患者138例,随机分为观察组和对照组各69例,分别经培美曲塞联合华蟾素、培美曲塞结合顺铂（DDP）治疗。对治疗效果、不良反应、癌胚抗原（CEA）及CA153水平进行观察比较,采用实体瘤疗效评估标准（RECIST 1.0）进行疗效评价。 结果观察组治疗后CA153水平由（47.63±5.28）U/ml降至（26.51±4.34）U/ml,CEA水平由（24.68±3.14）μg/L降至（8.83±2.45）μg/L;对照组CA153水平由（47.52±5.44）U/ml降至（34.58±4.92）U/ml,CEA水平由（23.75±3.20）μg/L降至（16.58±2.17）μg/L;治疗前两组差异无统计学意义,治疗后差异均有统计学意义（t=10.218、19.670,P=0.000、0.000）。观察组治疗后控制率、有效率分别为65.22%（45/69）、33.33%（23/69）,对照组分别为44.93%（31/69）、20.29%（14/69）,差异有统计学意义（χ²=5.740、4.333,P=0.017、0.037）。观察组恶心、呕吐、血小板减少、粒细胞减少、肝肾功能异常、脱发的发生率分别为46.38%、23.19%、37.68%、17.39%、2.90%,对照组分别为73.91%、47.83%、65.22%、36.23%、15.94%,差异有统计学意义（χ²=14.935,P<0.001）。 结论培美曲塞联合华蟾素作为晚期或转移性乳腺癌患者一线治疗的疗效较佳,可有效降低不良反应发生率,安全性高,适合临床推广。     

Combined treatment with by-pass operation, irradiation and immunochemotherapy for advanced thoracic esophageal cancer.

Based on the experimental results that operative stress of thoracotomy or laparothoracotomy has enhanced tumor growth remarkably in rats compared with laparotomy, a new combined treatment with by-pass operation, irradiation and immunochemotherapy was investigated in 39 advanced thoracic esophageal cancer patients. At by-pass operation, abdominal esophagus was divided and its proximal stump was closed immediately. Cervical esophagus was then divided and its distal stump was pulled out to the right supraclavicular region to make outer fistula. Thus, anticancer drug was poured into the esophagus through outer fistula very easily just before irradiation and then irradiation was performed under the condition that the lesion was immersed in the drugs. As anticancer agent, Mitomycin-C, 5-Fluorouracil or Bleomycin was given alternately. Lately, the combination of 5-Fluorouracil and Vitamin A was preferably used. The changes of immunological parameters and the survival after the onset of treatment was reported.     

奥沙利铂联合卡培他滨或联合替吉奥新辅助化疗方案在进展期胃癌治疗中的安全性和有效性

目的:探讨奥沙利铂联合卡培他滨（CapeOX）或奥沙利铂联合替吉奥（SOX）新辅助化疗方案在局部进展期胃癌治疗中的安全性和有效性。方法:采用回顾性队列研究方法,收集2016年4月至2019年4月期间,于上海交通大学医学院附属瑞金医院予以新辅助化疗并接受标准腹腔镜下胃癌根治术的进展期胃癌患者的临床资料。病例纳入标准：（1...     

热疗治疗晚期胰体尾癌22例效果分析

目的 探讨胰腺癌热疗术后并发症的预防和治疗。方法 回顾性分析2002年10月至2008年6月南京医科大学鼓楼临床医学院收治的22例热疗治疗晚期胰腺癌病人的临床资料,并复习相关文献。结果 所有病人均行射频消融或微波固化治疗,无围手术期死亡病例,1例病人出现胰瘘。结论 在术中超声引导下对不能手术切除的胰腺癌病人进行热疗治疗是较为安全有效的,但需更多临床资料证实。